Individual
JAMAR HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
(757) 735-0954
Mailing address
999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
(757) 735-0954
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
L47355
VA
Other
Enumeration date
10/24/2020
Last updated
10/24/2020
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