Individual
SERENA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E 2ND ST STE 4, COQUILLE, OR 97423-1864
(541) 824-0991
Mailing address
222 E 2ND ST STE 4, COQUILLE, OR 97423-1864
(541) 824-4099
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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