Individual
STEPHEN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 WADE CIR, KLAMATH FALLS, OR 97601-1581
(541) 883-7144
Mailing address
1700 WADE CIR, KLAMATH FALLS, OR 97601-1581
(541) 883-7144
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 10921
CA
Other
Enumeration date
10/15/2006
Last updated
07/08/2007
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