Individual
DANIELLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
51 RIVERWALK BLVD UNIT 3B, RIDGELAND, SC 29936-3201
(843) 781-4432
Mailing address
105 LISA ST APT K3, RINCON, GA 31326-9351
(912) 224-5538
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12339
SC
Other
Enumeration date
05/21/2022
Last updated
05/21/2022
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