| Nicholas James Long, | |
|
11740 Columbia St, Blakely, GA 39823-2574 | |
| (229) 723-2930 | |
| Not Available |
| Full Name | Nicholas James Long |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 11740 Columbia St, Blakely, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598094955 | NPI | - | NPPES |
| PT009781 | Other | GA | LICENSE NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT009781 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas James Long, 920 Cairo Rd, Reimbursement Department, Thomasville, GA 31792-4255 Ph: (229) 228-8800 | Nicholas James Long, 11740 Columbia St, Blakely, GA 39823-2574 Ph: (229) 723-2930 |
Linda W Wallace, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11740 Columbia St, Blakely, GA 39823 Phone: 229-724-4269 Fax: 229-723-2354 | |
Jeffrey E. Tardif, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11740 Columbia St, Blakely, GA 39823 Phone: 229-723-4241 |