Provider Demographics
NPI:1124249412
Name:CALLAWAY, LARYN ELIZABETH (ND)
Entity type:Individual
Prefix:DR
First Name:LARYN
Middle Name:ELIZABETH
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:LARYN
Other - Middle Name:E
Other - Last Name:CALLAWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NMD PLLC
Mailing Address - Street 1:4438 E CAMELBACK RD UNIT 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2839
Mailing Address - Country:US
Mailing Address - Phone:602-625-6322
Mailing Address - Fax:
Practice Address - Street 1:4438 E CAMELBACK RD UNIT 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2839
Practice Address - Country:US
Practice Address - Phone:602-625-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ98533175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath