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Organization

DEANNE LONG MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DEANNE LONG M.D. (OWNER)
(435) 713-1350
Entity
Organization

Contact information

Practice address
2380 N 400 E, LOGAN, UT 84341-6000
(435) 713-1354
Mailing address
PO BOX 571470, SALT LAKE CITY, UT 84157-1470
(310) 388-9012
(310) 388-9013

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
05/01/2009
Last updated
05/01/2009
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