Individual
SUSAN MARIE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
407 MAIN ST, LISBON, ND 58054-4143
(704) 683-5282
(701) 683-5218
Mailing address
7054 HIGHWAY 32, LISBON, ND 58054-9495
(701) 308-0734
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6070
ND
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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