Individual
MR. MICHAEL C LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
330 UPLAND WAY, GREEN RIVER, WY 82935-6401
(307) 875-4654
(307) 875-4641
Mailing address
2002 W SUNSET DR STE 1, RIVERTON, WY 82501-2285
(307) 856-7021
(307) 856-5546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1900
WY
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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