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Individual

ELLA DORAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
200 W CONSTANCE RD, SUFFOLK, VA 23434-4413
(757) 539-8744
Mailing address
501 SAWGRASS LN, PORTSMOUTH, VA 23703-2289
(757) 686-8736

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2305002005
VA

Other

Enumeration date
05/20/2008
Last updated
05/20/2008
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