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Individual

LAURIE E MOYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3530
Mailing address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3530

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002918
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811148133
VA
Enumeration date
10/06/2008
Last updated
01/27/2022
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