Individual
MS. CYNTHIA DANNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 LIZZIE LN, CANTON, MS 39046-9747
(601) 951-4974
Mailing address
116 LIZZIE LN, CANTON, MS 39046-9747
(601) 951-4974
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TA2092
MS
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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