Individual
MRS. KIMBERLY LYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12023 N RADIO STATION RD, SUITE A, SENECA, SC 29678-1143
(864) 985-0770
(864) 985-1770
Mailing address
PO BOX 1844, CLEMSON, SC 29633-1844
(864) 482-0064
(864) 482-0081
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4647
SC
Other
Enumeration date
11/09/2009
Last updated
12/12/2011
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