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Individual

REBECCA LAVERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT ATC

Contact information

Practice address
201 N BREAZEALE AVE, MOUNT OLIVE, NC 28365-1603
(919) 658-4954
Mailing address
1839 FOUNTAINTOWN RD, CHINQUAPIN, NC 28521-8705
(910) 340-4977

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-4048
NC

Other

Enumeration date
11/15/2022
Last updated
11/15/2022
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