Individual
LAVERNE RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 SW 9TH ST, AP B, HALLANDALE BEACH, FL 33009-7026
(340) 201-9561
Mailing address
100 SW 9TH ST, AP B, HALLANDALE BEACH, FL 33009-7026
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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