Individual
BOB ERVIN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
5903 E 35TH ST, TULSA, OK 74135-5305
(918) 289-0550
(918) 289-0551
Mailing address
5903 E 35TH ST, TULSA, OK 74135-5305
(918) 289-0550
(918) 289-0551
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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