Individual
LAWRENCE ALLEN WHITMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
113 LIELMANIS AVE, BLDG 91020, HURLBURT FIELD, FL 32544-5613
(850) 881-2106
Mailing address
113 LIELMANIS AVE, BLDG 91020, HURLBURT FIELD, FL 32544-5613
(850) 881-2106
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
12/19/2013
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