Individual
MICHALA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
3850 WEST MAIN ST, DOTHAN, AL 36305
(334) 794-6112
Mailing address
3291 JOHN CLARK RD, BONIFAY, FL 32425
(850) 263-1746
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11570
AL
183500000X
Pharmacist
PS 25537
FL
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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