Individual
MRS. TERESA KAY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, COHN-S
Contact information
Practice address
197 REPLACEMENT AVE, SUITE 139, FORT LEONARD WOOD, MO 65473-9089
(573) 329-1933
(573) 329-8521
Mailing address
126 MISSOURI AVE, OCCUPATIONAL HEALTH BOX 1227, FORT LEONARD WOOD, MO 65473-8952
(573) 329-1993
(573) 329-8521
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
103766
MO
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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