Organization
PEDSPLUS PEDIATRICS PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN LAURORE MD (MANAGER)
(347) 751-3641
Entity
Organization
Contact information
Practice address
621 JEFFERSON DAVIS HWY UNIT 11B, FREDERICKSBURG, VA 22401-4567
(347) 751-3641
Mailing address
1010 W KENSINGTON CIR, FREDERICKSBURG, VA 22401-8003
(347) 751-3641
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101243632
VA
Other
Enumeration date
06/28/2016
Last updated
06/30/2016
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