Individual
MARY LARAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2107 HOLLYBRIAR PT, NORFOLK, VA 23518-5320
(757) 857-5451
Mailing address
2107 HOLLYBRIAR PT, NORFOLK, VA 23518-5320
(757) 857-5451
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
0001128168
VA
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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