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Individual

JEREMY LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BOCPD

Contact information

Practice address
2503 ALBION AVE, BALTIMORE, MD 21214-2526
(828) 246-5040
Mailing address
2503 ALBION AVE, BALTIMORE, MD 21214-2526
(828) 246-5040

Taxonomy

Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary

Other

Enumeration date
07/29/2014
Last updated
07/29/2014
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