Individual
MR. LARRY D WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 HITE STREET, PO BOX 896, SOUTH HILL, VA 23970
(434) 532-5777
Mailing address
PO BOX 896, SOUTH HILL, VA 23970-0896
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T69515177
VA
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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