Individual
MR. MICHAEL BRANDON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
541 VELOCE TRL, FORT MILL, SC 29715-7826
(803) 547-0421
Mailing address
541 VELOCE TRL, FORT MILL, SC 29715-7826
(803) 547-0421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2751
NC
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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