Individual
ADAM ROBERT LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 E GORDON LN APT 20, SALT LAKE CITY, UT 84107-3120
(360) 649-7148
Mailing address
209 E GORDON LN APT 20, SALT LAKE CITY, UT 84107
(360) 649-7148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
13536800-3101
UT
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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