Individual
MR. EDWARD R LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1476 LONG GROVE DR STE 1, MOUNT PLEASANT, SC 29464-7571
(843) 216-3534
Mailing address
453 COMMONWEALTH RD, MT PLEASANT, SC 29466-8326
(843) 568-9306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2081
SC
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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