Individual
DR. JESSE K LAVERDIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-5811
Mailing address
1021 ALDER WAY APT 121, EVANS, GA 30809-9152
(724) 322-6181
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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