DR. Lara Diane Church, M.D.
NPI #1043280449 in Ponte Vedra, Florida
Provider Information
- NPI Number
- 1043280449
- Entity Type
- Individual
- Name
- DR. Lara Diane Church, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- M.D.
- Enumeration Date
- Jan 26, 2006
- Last Updated
- Dec 27, 2018
Practice Location
- Address
- 141 HILDEN RD STE 201
- Address 2
- CREDENTIALING DEPARTMENT
- City
- Ponte Vedra
- State
- Florida
- ZIP Code
- 32081-8400
- Phone
- (904) 825-1941
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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