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Individual

DR. LAURENCE R O'HALLORAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3299 WOODBURN RD, #300, ANNANDALE, VA 22003-1275
(703) 534-3314
(703) 698-1334
Mailing address
3299 WOODBURN RD, #300, ANNANDALE, VA 22003-1275
(703) 534-3314
(703) 698-1334

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101051134
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65-022-11
VA
Enumeration date
10/21/2005
Last updated
07/08/2007
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