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Individual

IJA LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
215 SHORTLEAF LN, HARVEST, AL 35749-4844
(256) 258-9305
Mailing address
1580 SPARKMAN DR NW STE 112, HUNTSVILLE, AL 35816-2680
(256) 258-9305

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
AL

Other

Enumeration date
03/25/2026
Last updated
03/25/2026
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