Provider Demographics
NPI:1346321379
Name:LAVOIE, GARY M
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:M
Last Name:LAVOIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2425
Mailing Address - Country:US
Mailing Address - Phone:508-226-4241
Mailing Address - Fax:508-223-3044
Practice Address - Street 1:508 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2425
Practice Address - Country:US
Practice Address - Phone:508-226-4241
Practice Address - Fax:508-223-3044
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA202-315-580OtherFEDERAL ID #