Individual
MR. HAROLD ALLEN LAVINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
917 BEVILLE RD, SOUTH DAYTONA, FL 32119-1712
(386) 756-4395
(866) 426-2811
Mailing address
1824 MOUNTAINSIDE AVE, SUFFOLK, VA 23434-6752
(757) 582-3930
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OP006634
PA
Other
Enumeration date
11/07/2008
Last updated
11/07/2008
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