Individual
DOUGLAS LONGMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-1993
Mailing address
819 4TH ST, NEW GLARUS, WI 53574-9426
(608) 527-2556
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10812-24
WI
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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