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Individual

MS. JAMIE ALLISON LANEAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT, CMCP

Contact information

Practice address
4124 E PARHAM RD, HENRICO, VA 23228-3745
(804) 647-9378
Mailing address
4124 E PARHAM RD, HENRICO, VA 23228-3745
(804) 647-9378

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
0019010723
VA
174400000X
Specialist
Primary
0019010723
VA

Other

Enumeration date
05/21/2014
Last updated
05/21/2014
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