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Mr. Rick J. Long

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NPI Number Detailed Information

Provider Information:

Name: Mr. Rick J. Long
Gender: M
Provider License Number If Given: 3550

NPI Information:

NPI: 1245233477
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 2/24/2010

Provider Business Mailing Address:

Address: 121 MAHALANI ST
Wailuku, HI 96793
Phone Number: 8089842150
Fax Number: 8089842155

Provider Business Practice Location Address:

Address: 121 MAHALANI ST
Wailuku, HI 96793
Phone Number: 8089842150
Fax Number:

Provider Taxonomy:

Primary: 1041C0700X
Secondary (if any):
State: HI

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