Individual
REBECCA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
518 28 RD, GRAND JUNCTION, CO 81501-6556
(970) 773-1423
Mailing address
1036 GILSONITE AVE, MACK, CO 81525-1004
(970) 773-1423
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0013988
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1865
—
CO
Enumeration date
01/31/2023
Last updated
01/31/2023
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