JONATHAN LIVELY

NORFOLK, VA
NPI1285763391
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: VA  0110002350)
Additional Taxonomies363A00000X Physician Assistant
(Licence: DC  PA030452)
Enumeration Date2007-03-05
Last Update Date2021-09-21
Business Address
JONATHAN LIVELY PA
600 GRESHAM DR STE 8630B
NORFOLK, VA 23507-1904
Phone number: 757-388-6115
Mailing Address
JONATHAN LIVELY PA
600 GRESHAM DR STE 8630B
NORFOLK, VA 23507-1904
Phone number: 757-388-6115