Organization
LONG'N 4 A NEW U, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATONYA RENEE LONG SPECIALIST (CERTIFIED HAIR LOSS SPECIALIST)
(856) 240-1095
Entity
Organization
Contact information
Practice address
613 WHITE HORSE PIKE, HADDON TOWNSHIP, NJ 08107-1219
(856) 240-1095
Mailing address
613 WHITE HORSE PIKE, HADDON TOWNSHIP, NJ 08107-1219
(856) 240-1095
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
32WG06189000
NJ
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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