Individual
JARID KEITH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
804 VALENTINE LN, PAPILLION, NE 68046-6236
(402) 672-1484
Mailing address
804 VALENTINE LN, PAPILLION, NE 68046-6236
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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