Most Relevant Information
Provider Data
| NPI Number: | 1003308529 |
| Provider Name: | ELIZABETH LONGO |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2018 |
| Last Updated: | 05/31/2018 |
Provider Practice Location
5756 REDFORD CV
BARTLETT
TN
381351408
Practice Location Phone/Fax
| Phone: | 9012404930 |
| Fax: |
Provider Mailing Location
5756 REDFORD CV
BARTLETT
TN
381351408
Provider Mailing Phone/Fax
| Phone: | 9012404930 |
| Fax: |