Individual
MRS. ANNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
4150 SILVERADO DR, IDAHO FALLS, ID 83404-7788
(208) 589-3271
(208) 529-3295
Mailing address
4150 SILVERADO DR, IDAHO FALLS, ID 83404-7788
(208) 589-3271
(208) 529-3295
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-325
ID
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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