| NPI | 1902220379 |
|---|---|
| Professional Name | JOHN DAVID LAVENDER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NC 0169) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2014-02-06 |