Organization
ALFRED M. LONG, JR., O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED M LONG JR. OD (OWNER)
(770) 313-7286
Entity
Organization
Contact information
Practice address
690 STONE HOUSE LN NW, MARIETTA, GA 30064-4700
(770) 313-7286
Mailing address
690 STONE HOUSE LN NW, MARIETTA, GA 30064-4700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001218
GA
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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