Individual
TRAVIS JOHN LAVERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 NJ-73, VOORHEES TOWNSHIP, NJ 08043
(856) 282-1338
Mailing address
100 NJ-73, VOORHEES TOWNSHIP, NJ 08043
(856) 282-1338
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
25MP00616900
NJ
208600000X
Surgery Physician
25MP00616900
NJ
Other
Enumeration date
12/09/2020
Last updated
06/06/2024
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