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1598371320
JONATHAN BYRON LIVELY
CHARLOTTE, NC
NPI
1598371320
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-10599)
Enumeration Date
2020-09-17
Last Update Date
2024-07-15
Business Address
JONATHAN BYRON LIVELY PA
1426 E MOREHEAD ST
CHARLOTTE, NC 28204-2926
Phone number: 704-446-6090
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Mailing Address
JONATHAN BYRON LIVELY PA
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number:
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