Individual
BETH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 W BEACON ST, PHILADELPHIA, MS 39350-3204
(601) 656-5310
Mailing address
114 MEAGAN ST, PHILADELPHIA, MS 39350-9797
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-08113
MS
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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