Individual
JIMMY TAFT LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1330 KINARD ST, NEWBERRY, SC 29108-3038
(803) 405-1585
Mailing address
828 BELTLINE BLVD, COLUMBIA, SC 29205-2063
(803) 513-5397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3691
SC
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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