Provider Demographics
NPI:1982098331
Name:RIVERWIND, LARALYN
Entity Type:Individual
Prefix:DR
First Name:LARALYN
Middle Name:
Last Name:RIVERWIND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13894 US 19
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-5200
Mailing Address - Country:US
Mailing Address - Phone:919-447-1000
Mailing Address - Fax:
Practice Address - Street 1:13894 US 19
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-5200
Practice Address - Country:US
Practice Address - Phone:919-447-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath