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Individual

KOREY J LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
6301 FORBES AVE, SUITE 120, PITTSBURGH, PA 15217-1725
(412) 421-7400
Mailing address
6301 FORBES AVE, SUITE 120, PITTSBURGH, PA 15217-1725
(412) 421-7400

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009495
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11528085
CAQH
Enumeration date
03/22/2011
Last updated
03/22/2011
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