Individual
EDITH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 COUNTRY CLUB BLVD, WEIRTON, WV 26062-9681
(740) 632-7680
Mailing address
209 COUNTRY CLUB BLVD, WEIRTON, WV 26062-9681
(740) 632-7680
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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