Individual
DENNIS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 ASH RD, SOUTHPORT, NC 28461-9115
(910) 338-2272
(910) 338-2284
Mailing address
16 ASH RD, SOUTHPORT, NC 28461-9115
(910) 338-2272
(910) 338-2284
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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