Individual
DANIEL EVERETT LONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
520 COOK ST, SUITE D, MADISONVILLE, TN 37354-1508
(423) 442-1440
(423) 442-1441
Mailing address
520 COOK ST, SUITE D, MADISONVILLE, TN 37354-1508
(423) 442-1440
(423) 442-1441
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT0000006076
TN
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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