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1124364070
ALICIA LYNNE IBANEZ
CHARLOTTE, NC
NPI
1124364070
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NC 0010-03995)
Enumeration Date
2012-12-21
Last Update Date
2015-07-20
Business Address
-- ALICIA LYNNE IBANEZ P.A.
2131 AYRSLEY TOWN BLVD SUITE 400
CHARLOTTE, NC 28273-3595
Phone number: 980-297-7733
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Mailing Address
-- ALICIA LYNNE IBANEZ P.A.
120 CHANDELEUR DR
MOORESVILLE, NC 28117-5954
Phone number: 508-335-6122
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