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1316392061
ALPHONSO IVY
SAINT LOUIS, MO
NPI
1316392061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: MO 2016012675)
Enumeration Date
2016-05-02
Last Update Date
2016-05-02
Business Address
-- ALPHONSO IVY PLPC
1323 SULLIVAN AVE
SAINT LOUIS, MO 63107-3919
Phone number: 314-503-1746
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Mailing Address
-- ALPHONSO IVY PLPC
1323 SULLIVAN AVE
SAINT LOUIS, MO 63107-3919
Phone number: 314-503-1746
Copy
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