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1306256250
LARISSA ANNE KAVANAGH
CHARLOTTE, NC
NPI
1306256250
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-05013)
Enumeration Date
2014-04-30
Last Update Date
2024-07-17
Business Address
LARISSA ANNE KAVANAGH PA
10650 PARK RD
CHARLOTTE, NC 28210-8538
Phone number: 704-667-3840
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Mailing Address
LARISSA ANNE KAVANAGH PA
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number:
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