Individual
MADELYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
928 W MARKET ST STE A, TIFFIN, OH 44883-2529
(419) 447-2927
Mailing address
109 W MAIN ST, SHILOH, OH 44878-9749
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010463
OH
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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