Individual
MARIANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 RICHMOND RD, LEXINGTON, KY 40502-1204
(859) 266-2101
Mailing address
PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA371
KY
Other
Enumeration date
02/04/2006
Last updated
11/16/2012
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