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1790010528
LARRY ALAN LAVENDER
ROME, GA
NPI
1790010528
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: GA RN170718)
Enumeration Date
2009-10-13
Last Update Date
2009-10-13
Business Address
-- LARRY ALAN LAVENDER CRNA
304 TURNER MCCALL BLVD SW
ROME, GA 30165-5621
Phone number: 706-291-2131
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Mailing Address
-- LARRY ALAN LAVENDER CRNA
20 PRESTWICK LOOP NW
CARTERSVILLE, GA 30120-7789
Phone number: 678-721-9981
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