Individual
JOSEPH MAXWELL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, SCAT, BS
Contact information
Practice address
117 RUSSELL RD APT 201, CAYCE, SC 29033-1983
(803) 487-3510
Mailing address
117 RUSSELL RD APT 201, CAYCE, SC 29033-1983
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-3116
NC
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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