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Willie Nathaniel Long Valid NPI

Individual provider · Durable Medical Equipment & Medical Supplies · Stafford, TX

NPI
1659441194
Type
Individual (Type 1)
Primary specialty
Durable Medical Equipment & Medical Supplies
Specialty group
Suppliers
Taxonomy code
332B00000X
License number
32010589631 (TX)
Sex
Male
Sole proprietor
Yes
Enumerated
2006-11-09
Last updated
2007-07-08
Practice location
610 Murphy Rd Ste 107
Stafford, TX 77477-5926
(281) 261-9616

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