Individual
ALLIE K LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
041394426
IL
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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