Individual
JACQUELYN RUTH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4403 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 395-3910
(937) 395-3950
Mailing address
1199 WALNUT VALLEY LN, DAYTON, OH 45458-9583
(440) 488-3098
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT013294
OH
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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