Individual
MRS. AMANDA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5200 EXECUTIVE CENTRE PKWY STE 200, SAINT PETERS, MO 63376-3394
(636) 255-8750
(636) 244-1172
Mailing address
647 SPIRIT AIRPARK WEST DR STE 101, CHESTERFIELD, MO 63005-1032
(636) 206-4225
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2021014458
MO
225100000X
Physical Therapist
9707
SC
Other
Enumeration date
06/04/2019
Last updated
08/24/2023
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