Individual
MR. MARK A. LAFORME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
216 BUNKER CT, JACKSONVILLE, NC 28540-9306
(703) 944-4629
Mailing address
216 BUNKER CT, JACKSONVILLE, NC 28540-9306
(703) 944-4629
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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