Individual
ANTHONY WILLIAM LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
801 7TH ST, SANTA ROSA, CA 95404-4213
(415) 855-5699
Mailing address
801 7TH ST, SANTA ROSA, CA 95404-4213
(415) 855-5699
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
71075
CA
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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