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General NPI Number Information
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NPI Number | 1275090409
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Entity Type | Individual
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Provider Name | DR. CONNER LARAWAY
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Gender | Male
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Dates
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Enumeration Date | 02/24/2019
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Last Update Date | 02/24/2019
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Provider Practice Location Address
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Address Line | 512 WESTFIELD RD
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City | HOLYOKE
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State | MA
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Zip | 01040-1633
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Country | US
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Telephone | 413-626-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 1166 E MOUNTAIN RD
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City | WESTFIELD
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State | MA
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Zip | 01085-1405
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Country | US
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Telephone | 413-572-1219
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3639
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License Number State | MA
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