Individual
BRANDY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3456 21ST AVE S, ST PETERSBURG, FL 33711-3213
(727) 512-0255
Mailing address
1120 35TH AVE N, ST PETERSBURG, FL 33704-1853
(727) 512-0255
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19180
FL
Other
Enumeration date
04/25/2007
Last updated
04/29/2015
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