Individual
MOLLY U LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1847 W HEATHERBRAE DR STE A, PHOENIX, AZ 85015-4764
(602) 274-2100
(602) 535-3166
Mailing address
7017 S PRIEST DR APT 3091, TEMPE, AZ 85283-6048
(314) 596-8319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9847
AZ
Other
Enumeration date
08/19/2006
Last updated
03/15/2024
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