Individual
BETTY JANE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 BUTLER AVE, MIDWAY, GA 31320
(912) 884-9255
Mailing address
3527 COUNTY LINE RD, HINESVILLE, GA 31313-7419
(912) 876-3614
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PS9366
FL
183500000X
Pharmacist
PU234
FL
183500000X
Pharmacist
Primary
RPH011227
GA
Other
Enumeration date
08/07/2006
Last updated
07/08/2007
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