Individual
JOHNNY RAY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 CORRAL RD, RUIDOSO DOWNS, NM 88346-9492
(575) 973-1417
Mailing address
PO BOX 8144, RUIDOSO, NM 88355-8144
(575) 973-1417
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
About Stedi
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