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General NPI Number Information
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NPI Number | 1245347483
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Entity Type | Individual
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Provider Name | PAUL D. LAVIGNE EMT
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | USAHC GRAF CMR 415
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City | APO
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State | AE
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Zip | 09114
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Country | DE
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Telephone | 09641837152
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 415 BOX 3569
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City | APO
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State | AE
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Zip | 09114
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Country | DE
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Telephone | 09641925870
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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 | 374700000X
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Taxonomy Name | Technician
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License Number | B1498591
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License Number State | TX
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