NPI 1609386721

Johnny Ray Long

Practitioner Private Vehicle Ruidoso Downs, NM

Practice location

Address: 102 Corral Rd, Ruidoso Downs, NM 88346-9492
Phone: (575) 973-1417
Mailing address: PO Box 8144, Ruidoso, NM 88355-8144

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1609386721
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Oct 2017
Record last updated: 3 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.