Provider Demographics
NPI:1467885897
Name:LONG, ZACHARY K (DPT)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:K
Last Name:LONG
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Gender:M
Credentials:DPT
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Mailing Address - Street 1:8912 BLAKENEY PROFESSIONAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6734
Mailing Address - Country:US
Mailing Address - Phone:704-301-1449
Mailing Address - Fax:704-544-5382
Practice Address - Street 1:8912 BLAKENEY PROFESSIONAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6734
Practice Address - Country:US
Practice Address - Phone:704-301-1449
Practice Address - Fax:704-544-5382
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2015-05-18
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Provider Licenses
StateLicense IDTaxonomies
NC14411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist