Individual
LOUIS EUGENE RAIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
217 HERITAGE OAK DR, CHESAPEAKE, VA 23320-9501
(910) 478-6773
Mailing address
217 HERITAGE OAK DR, CHESAPEAKE, VA 23320-9501
(910) 478-6773
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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