Individual
JAMILEI MICHELLE ALWORDEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
#6 SALLISAW VIEW DR, SALLISAW, OK 74955
(940) 447-7912
Mailing address
#6 SALLISAW VIEW DR, SALLISAW, OK 74955
(940) 447-7912
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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