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Individual

PATRICIA AUGUSTA LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.ED, ATC, CSCS

Contact information

Practice address
1895 BAYOU DR, NAVARRE, FL 32566-7601
(914) 656-3126
Mailing address
601 INDEPENDENCE RD, HURLBURT FIELD, FL 32544-5601
(914) 656-3126

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3721
FL

Other

Enumeration date
01/08/2021
Last updated
01/08/2021
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