Provider Demographics
NPI:1386845295
Name:LONG, TOBY MARY (PHD, PT)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:MARY
Last Name:LONG
Suffix:
Gender:F
Credentials:PHD, PT
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Mailing Address - Street 1:5611 ONTARIO CIR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2461
Mailing Address - Country:US
Mailing Address - Phone:301-229-3018
Mailing Address - Fax:202-687-8899
Practice Address - Street 1:GEORGETOWN UNIVERSITY
Practice Address - Street 2:3300 WHITEHAVEN ST
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-1485
Practice Address - Country:US
Practice Address - Phone:202-687-8742
Practice Address - Fax:202-687-8899
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCPT469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist