Individual
SUSAN S LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 BEAM RD, COLUMBUS, IN 47203-3405
(812) 378-4701
Mailing address
2400 BEAM RD, COLUMBUS, IN 47203-3405
(812) 378-4701
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017484A
IN
183500000X
Pharmacist
6527
CT
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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