Individual
DOMINIQUE CALLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 POTATO NECK RD, PORT HAYWOOD, VA 23138-2020
(804) 384-6922
Mailing address
619 POTATO NECK RD, PORT HAYWOOD, VA 23138-2020
(804) 384-6922
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
03435
VA
Other
Enumeration date
04/18/2026
Last updated
04/18/2026
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