Provider Demographics
NPI:1952723744
Name:LONG, BARBARA (EDD, VATL, ATC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:EDD, VATL, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E COLLEGE ST
Mailing Address - Street 2:COLLEGE BOX 152
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1511
Mailing Address - Country:US
Mailing Address - Phone:540-828-5771
Mailing Address - Fax:540-828-5734
Practice Address - Street 1:402 E COLLEGE ST
Practice Address - Street 2:COLLEGE BOX 152
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812-1511
Practice Address - Country:US
Practice Address - Phone:540-828-5771
Practice Address - Fax:540-828-5734
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260003922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer