Individual
MR. BRIAN ANTHONY LO ONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
N64W24086 MAIN ST, SUSSEX, WI 53089-3002
(262) 785-7722
Mailing address
N64W24086 MAIN ST, SUSSEX, WI 53089-3002
(262) 785-7722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
30170
CA
225100000X
Physical Therapist
Primary
9753-024
WI
Other
Enumeration date
04/09/2008
Last updated
06/25/2020
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