Individual
JACQUELINE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 CAMPUS DR, MISSOULA, MT 59812-0003
(406) 243-2703
Mailing address
915 E BECKWITH AVE, MISSOULA, MT 59801-5834
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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