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Individual

MRS. LATONYA RENEE LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
613 WHITE HORSE PIKE, HADDON TOWNSHIP, NJ 08107-1219
(856) 240-1095
Mailing address
613 WHITE HORSE PIKE, HADDON TOWNSHIP, NJ 08107-1219
(856) 240-1095

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
32WG06189000
NJ

Other

Enumeration date
04/11/2017
Last updated
04/11/2017
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