Individual
VICTORIA O LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4152 W SPRING CREEK PKWY, PLANO, TX 75024-5314
(972) 612-5363
Mailing address
3948 LEGACY DR., 106 PMB# 155, PLANO, TX 75023
(214) 558-7789
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT108736
TX
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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