Individual
TERESA D LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1119 LAKE BLUFF CIR, LOUISVILLE, KY 40245-5239
(502) 552-3530
(502) 290-0543
Mailing address
1119 LAKE BLUFF CIR, LOUISVILLE, KY 40245-5239
(502) 552-3530
(502) 290-0543
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002535
KY
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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