Individual
ANGELA LONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2617 W 16TH STREET, BEDFORD, IN 47421
(812) 279-3701
(812) 279-3701
Mailing address
2617 W 16TH STREET, BEDFORD, IN 47421
(812) 279-3701
(812) 279-3701
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002841B
IN
Other
Enumeration date
04/11/2006
Last updated
07/08/2007
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