Individual
DR. NICOLE L LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4902 TACOMA MALL BLVD, TACOMA, WA 98409-7149
(253) 473-0300
(253) 473-0305
Mailing address
18729 88TH AVE., E, PUYALLUP, WA 98375
(253) 262-1408
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00033851
WA
Other
Enumeration date
09/25/2006
Last updated
05/15/2008
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