Individual
LAURA VIRGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4881 SUGAR MAPLE DRIVE, OFFICE SYMBOL: SGXW, WRIGHT-PATTERSON AFB, OH 45433
(937) 775-7792
Mailing address
4881 SUGAR MAPLE DRIVE, OFFICE SYMBOL: SGXW, WRIGHT-PATTERSON AFB, OH 45433
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.139781
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2018
Last updated
07/03/2022
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