Nydia Long, LDO

NPI 1972360998 · on the registry since 2024 · sole proprietor

Practice

Address: 2050 W Spring St
Monroe, GA 30655
Phone: (770) 267-1237
Fax: (770) 267-3079
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-03-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia