Individual
DUSTIN DAVID LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 W MAIN ST, HENDERSON, TX 75652-2923
(903) 657-6513
Mailing address
616 WILLOW RD, HALLSVILLE, TX 75650-6144
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2148454
TX
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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