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Organization

TORCH WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARA KAIN PA-C (OWNER)
(757) 603-4604
Entity
Organization

Contact information

Practice address
117 W 21ST ST STE 205, NORFOLK, VA 23517-2246
(757) 603-4604
Mailing address
117 W 21ST ST STE 205, NORFOLK, VA 23517-2246
(757) 603-4604

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110001645
LICENSE
VA
Enumeration date
05/12/2022
Last updated
05/12/2022
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