Individual
CHAUNCEY MONROE LONG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 E AUGLAIZE ST, WAPAKONETA, OH 45895-1577
(567) 356-4400
Mailing address
1839 OLYMPIA CIR, LIMA, OH 45805-5103
(419) 302-1974
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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