Individual
TONY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1011 11TH ST RM 104, RAPID CITY, SD 57701-3530
(605) 791-6346
Mailing address
269 MINNESOTA ST, RAPID CITY, SD 57701-6205
(605) 393-5978
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
R039099
SD
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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