BRIAN LAVERENTZ

TACOMA, WA
NPI1134864952
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208D00000X General Practice
(Licence: VA  0102208192)
Enumeration Date2022-05-05
Last Update Date2023-09-05
Business Address
BRIAN LAVERENTZ
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 706-787-5811
Mailing Address
BRIAN LAVERENTZ
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number:
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