Individual
ADAM LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1331 LAKE DR SE, SUITE 105, GRAND RAPIDS, MI 49506-1674
(616) 248-9842
Mailing address
104 RED PAINT RDG, CLARKSVILLE, TN 37043-1529
(931) 220-9647
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501017822
MI
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/11/2016
Last updated
02/20/2019
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