Individual
MR. ALBERT LONGSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5620 E FARMRIDGE DR, TUCSON, AZ 85756-9731
(520) 663-5620
Mailing address
5620 E FARMRIDGE DR, TUCSON, AZ 85756-9731
(520) 663-5620
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1152511
AZ
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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