Individual
MS. JUDITH ANN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THERAPIST
Contact information
Practice address
109 N EVANS, BRADNER, OH 43406-0212
(419) 288-3202
Mailing address
109 N EVANS, P.O.BOX 212, BRADNER, OH 43406-0212
(419) 288-3202
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
238639
CA
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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