Individual
GINA M LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
185 N MAIN ST, SUFFIELD, CT 06078-2116
(860) 386-4487
Mailing address
310 WOODGATE CIR, ENFIELD, CT 06082-5573
(908) 477-7840
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001158
CT
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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