Individual
AMY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
430 PENNSYLVANIA AVE, GLEN ELLYN, IL 60137-4464
(630) 469-9200
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013376
IL
Other
Enumeration date
02/12/2007
Last updated
06/08/2023
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