Individual
CYNTHIA DIANA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 PIN OAK LN SE, CALHOUN, GA 30701-4090
(678) 451-5028
Mailing address
132 PIN OAK LN SE, CALHOUN, GA 30701-4090
(678) 451-5028
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
PHCP013061
GA
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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