Individual
STEPHANIE C. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2185 S MASON RD, SAINT LOUIS, MO 63131-1640
(314) 821-5666
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2014028346
MO
Other
Enumeration date
08/12/2014
Last updated
08/17/2022
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