Individual
RYAN PORTER LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
1316 WEST HWY 40, VERNAL, UT 84078-8811
(435) 789-7936
Mailing address
1316 WEST HWY 40, VERNAL, UT 84078-8811
(435) 789-7936
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7344956-1701
UT
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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