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Individual

MS. LORI L LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
698 MICHELLE DR, BILOXI, MS 39532-4504
(228) 861-3274
Mailing address
PO BOX 6864, DIBERVILLE, MS 39540-6864
(228) 861-3274

Taxonomy

Speciality
Code
Description
License number
State
3418M1110X
Military or U.S. Coast Guard Ground Transport Ambulance
5987495
MS
343900000X
Non-emergency Medical Transport (VAN)
Primary
5987495
MS
344600000X
Taxi
5987495
MS

Other

Enumeration date
09/28/2018
Last updated
09/28/2018
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