Individual
MRS. KENDRA RAY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4823 S LABURNUM AVE STE A, RICHMOND, VA 23231-2713
(804) 564-5852
Mailing address
4823 S LABURNUM AVE STE A, RICHMOND, VA 23231-2713
(804) 564-5852
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007047
VA
Other
Enumeration date
01/12/2019
Last updated
05/22/2023
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