person
Susan Long
Optician in Gallup, New Mexico
NPI 1326104787

Susan Long is a Optician based in Gallup, NM and is specialized in Optician. Susan Long practices in Gallup, NM. The NPI Number for Susan Long is 1326104787 and holds a License No. 03-037772-00-2 (New Mexico).

The current practice location address for Susan Long is 1300 W I-40 Frontage Rd Ste 322, Gallup, NM and can be reached out via phone at 505-722-3030 and via fax at 505-722-0367.

Location: 1300 W I-40 Frontage Rd Ste 322, Gallup, NM, 87301-3323
person
Provider Profile Details
NPI Number
1326104787
Provider Name
Susan Long
Credential
Provider Entity Type
Individual
Gender
Female
Address
1300 W I-40 Frontage Rd Ste 322, Gallup, NM, 87301-3323
Phone Number
505-722-3030
Fax Number
505-722-0367
Provider Enumeration Date
12/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
90481763 05 NM
institution
Provider Business Practice Location Address Details
Address
1300 W I-40 Frontage Rd Ste 322
City
State
Zip
87301-3323
Phone Number
505-722-3030
Fax Number
505-722-0367
person
Provider Business Mailing Address Details
Address
1300 W I-40 Frontage Rd Ste 322
City
State
Zip
87301-3323
Phone Number
505-722-3030
Fax Number
505-722-0367
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
03-037772-00-2 (New Mexico)
Definition
Definition to come...
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