Individual
ROSCOE CALLAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CONTRACTOR
Contact information
Practice address
1121 CAMPOSTELLA RD, NORFOLK, VA 23523-2103
(757) 543-0843
(757) 543-0504
Mailing address
1121 CAMPOSTELLA RD, NORFOLK, VA 23523-2103
(757) 543-0843
(757) 543-0504
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2705158786
VA
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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