Individual
JOSHUA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3400 N WESLEYAN BLVD, ROCKY MOUNT, NC 27804-8699
(440) 479-2639
Mailing address
3400 N WESLEYAN BLVD, ROCKY MOUNT, NC 27804-8699
(440) 479-2639
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1630
NC
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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