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1134864952
BRIAN LAVERENTZ
TACOMA, WA
NPI
1134864952
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208D00000X General Practice
(Licence: VA 0102208192)
Enumeration Date
2022-05-05
Last Update Date
2023-09-05
Business Address
BRIAN LAVERENTZ
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 706-787-5811
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Mailing Address
BRIAN LAVERENTZ
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number:
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