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1235703471
RAVIN JAYATISSA
LUMBERTON, NC
NPI
1235703471
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-05-13
Last Update Date
2021-05-13
Business Address
RAVIN JAYATISSA MD
730 OAKRIDGE BLVD
LUMBERTON, NC 28358-2324
Phone number: 910-738-2662
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Mailing Address
RAVIN JAYATISSA MD
300 W 27TH ST
LUMBERTON, NC 28358-3075
Phone number: 910-738-2662
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