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Individual

ROBERT B LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
10 MISSILE AVE, MINOT AFB, ND 58705-5003
(701) 723-5474
Mailing address
1 8TH ST NW, MINOT, ND 58703-3038
(701) 852-0408

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
07/07/2009
Last updated
07/07/2009
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