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Individual

KATHERINE KNOLL LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3280 DAUPHIN ST STE A103, MOBILE, AL 36606-4048
(251) 459-8402
(251) 459-8403
Mailing address
1908 FLINT RD SE, DECATUR, AL 35601-6031
(256) 340-9708
(256) 340-9624

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 19574
FL
225100000X
Physical Therapist
Primary
PTH5448
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003819608
GROUP NPI
AL
05
529917620
AL
Enumeration date
01/20/2010
Last updated
11/18/2014
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