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Individual

DR. KRYSTAL L. LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3232 13TH AVE S, FARGO, ND 58103-3403
(701) 280-3000
(701) 280-1304
Mailing address
3232 13TH AVE S, FARGO, ND 58103-3403
(701) 280-3000
(701) 280-1304

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3297
MN
152W00000X
Optometrist
6140
OH
152W00000X
Optometrist
Primary
771
ND

Other

Enumeration date
07/16/2012
Last updated
02/27/2023
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