Individual
JENNIFER LYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
800 E MAIN ST STE 310, WYTHEVILLE, VA 24382-3311
(276) 228-6200
Mailing address
375 VERMILLION DR, BLUEFIELD, VA 24605-9349
(276) 970-3736
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119-007269
VA
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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