Individual
MR. LAWRENCE CARLYLE HEADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
30972 MEADOWBROOK AVE, HAYWARD, CA 94544-7544
(954) 655-3696
(510) 400-9095
Mailing address
30972 MEADOWBROOK AVE, HAYWARD, CA 94544-7544
(954) 655-3696
(510) 400-9095
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
707397
IL
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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