person
Kelly Lynn Long, PA-C
Medical Physician Assistant in Plymouth, Michigan
NPI 1568623338

Kelly Lynn Long is a Medical Physician Assistant based in Plymouth, MI and is specialized in Medical. Kelly Lynn Long practices in Plymouth, MI and has the professional credentials of PA-C. The NPI Number for Kelly Lynn Long is 1568623338 and holds a License No. 5601003518 (Michigan).

The current practice location address for Kelly Lynn Long is 500 Ross St, Plymouth, MI and can be reached out via phone at 734-341-7767 and via fax at 734-893-3131.

Location: 500 Ross St, Plymouth, MI, 48170-2206
person
Provider Profile Details
NPI Number
1568623338
Provider Name
Kelly Lynn Long
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
500 Ross St, Plymouth, MI, 48170-2206
Phone Number
734-341-7767
Fax Number
734-893-3131
Provider Enumeration Date
06/24/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5601003518 01 MI MICHIGAN LICENSE
institution
Provider Business Practice Location Address Details
Address
500 Ross St
City
State
Zip
48170-2206
Phone Number
734-341-7767
Fax Number
734-893-3131
person
Provider Business Mailing Address Details
Address
500 Ross St
City
State
Zip
48170-2206
Phone Number
734-341-7767
Fax Number
734-893-3131
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5601003518 (Michigan)
Definition
Definition to come...
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