Individual
HENRY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 S RAINBOW BLVD, LAS VEGAS, NV 89145-6232
(702) 877-2162
Mailing address
1001 S RAINBOW BLVD, LAS VEGAS, NV 89145-6232
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19406
NV
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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