Provider Demographics
NPI:1598880429
Name:LONG, JAMES PERCY III (PT, MA, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PERCY
Last Name:LONG
Suffix:III
Gender:M
Credentials:PT, MA, CSCS
Other - Prefix:
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Mailing Address - Street 1:3081 COLERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1730 W. 25TH ST.
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3108
Practice Address - Country:US
Practice Address - Phone:216-363-2288
Practice Address - Fax:216-696-7485
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHPT 002017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist