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Individual

KARLA LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
413 W MAIN ST, MANTON, MI 49663-9156
(231) 884-2739
Mailing address
413 WEST MAIN ST, PO BOX 173, MANTON, MI 49663
(231) 884-2739

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001770
MI

Other

Enumeration date
11/01/2013
Last updated
11/01/2013
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