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Individual

MR. KEITH STAPLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1310 8TH ST, SUITE 100, NORFOLK, VA 23521-2416
(757) 462-8624
Mailing address
1021 SILVER CHARM CIR, SUITE 100, SUFFOLK, VA 23435-3340
(757) 334-2023
(757) 462-4798

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
12/05/2007
Last updated
12/05/2007
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