Individual
PERRIS DWAYNE SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
3701 KECOUGHTAN RD, HAMPTON, VA 23669-4405
(757) 728-2913
(757) 728-3886
Mailing address
377 TYLER AVE, NEWPORT NEWS, VA 23601-4109
(757) 818-1074
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230022698
VA
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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