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1194963454
LAWRENCE WAYNE SHIVERTAKER
ORANGE PARK, FL
NPI
1194963454
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
202C00000X Independent Medical Examiner
(Licence: FL me60157)
Enumeration Date
2009-01-25
Last Update Date
2009-01-25
Business Address
Dr. LAWRENCE WAYNE SHIVERTAKER MD
2486 SHALIMAR LN
ORANGE PARK, FL 32073-6123
Phone number: 904-269-5274
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Mailing Address
Dr. LAWRENCE WAYNE SHIVERTAKER MD
2486 SHALIMAR LN
ORANGE PARK, FL 32073-6123
Phone number: 904-269-5274
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