Individual
LAVAUGHN MURRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1660 GRAYS RD, PORT REPUBLIC, MD 20676-2146
(301) 455-5054
Mailing address
1660 GRAYS RD, PORT REPUBLIC, MD 20676-2146
(301) 455-5054
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M600488469244
MD
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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