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Individual

MS. SUE A LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2 KEEWAYDIN DRIVE, CORE MEDICAL GROUP, SALEM, NH 03079
(800) 995-2673
(888) 979-6551
Mailing address
2 KEEWAYDIN DRIVE, CORE MEDICAL GROUP, SALEM, NH 03079
(413) 717-4025

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
000815
CT
225200000X
Physical Therapy Assistant
2873
MA
225200000X
Physical Therapy Assistant
Primary
40QB00304300
NJ
225200000X
Physical Therapy Assistant
TE009711
PA

Other

Enumeration date
02/04/2008
Last updated
05/14/2014
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