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General NPI Number Information
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NPI Number | 1083293724
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Entity Type | Individual
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Provider Name | ALEC DAVID LAVERE DPT
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Gender | Male
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 6055 ARMOR DUELLS RD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-3150
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Country | US
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Telephone | 716-508-3026
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Fax |
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Provider Business Mailing Address
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Address Line | 455 SARAH NICOLE WAY
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-5416
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Country | US
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Telephone | 716-908-6242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 046595
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT41855
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License Number State | FL
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