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Individual

MR. DOUGLAS LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.P.H

Contact information

Practice address
105A BROYLES ST, JOHNSON CITY, TN 37601-2517
(423) 282-1178
(423) 282-0462
Mailing address
105A BROYLES ST, JOHNSON CITY, TN 37601-2517
(423) 282-1178
(423) 282-0462

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1174
TN

Other

Enumeration date
06/23/2006
Last updated
07/08/2007
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