Most Relevant Information
Provider Data
| NPI Number: | 1003666991 |
| Provider Name: | MATTHEW GUILFORD LONG |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/25/2024 |
| Last Updated: | 03/25/2024 |
Provider Practice Location
625 19TH ST S
BIRMINGHAM
AL
352331900
Practice Location Phone/Fax
| Phone: | 2059346007 |
| Fax: |
Provider Mailing Location
625 19TH ST S
BIRMINGHAM
AL
352331900
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |