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Individual

MICHAEL LAWRENCE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
602 WOODBRIDGE AVE, LOGANSPORT, IN 46947-1661
(574) 753-3223
Mailing address
1320 SMITH ST APT 216, LOGANSPORT, IN 46947-1567
(574) 727-1786

Taxonomy

Speciality
Code
Description
License number
State
364SL0600X
Long-Term Care Clinical Nurse Specialist
Primary
28193730A
IN

Other

Enumeration date
07/27/2022
Last updated
07/27/2022
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