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1205207529
LAVORRIS WHITE
MACON, GA
NPI
1205207529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: GA 0945091332)
Enumeration Date
2015-10-13
Last Update Date
2015-10-13
Business Address
Mr. LAVORRIS WHITE
205 ASHTON CT
MACON, GA 31220-8337
Phone number: 478-960-1856
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Mailing Address
Mr. LAVORRIS WHITE
205 ASHTON COURT
MACON, GA 31220
Phone number: 478-960-1856
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