Individual
LARON D WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5003 COLONIAL PARK DR APT D, SOUTH CHARLESTON, WV 25309-2049
(681) 945-7421
Mailing address
5003 COLONIAL PARK DR APT D, SOUTH CHARLESTON, WV 25309-2049
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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