JONATHON MICHAEL LAVALLEY

GRANTS, NM
NPI1871915702
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NM  PA2013-0089)
Enumeration Date2014-01-12
Last Update Date2014-01-12
Business Address
-- JONATHON MICHAEL LAVALLEY PA-C
1423 E ROOSEVELT AVE
GRANTS, NM 87020-2245
Phone number: 505-287-6500
Mailing Address
-- JONATHON MICHAEL LAVALLEY PA-C
1423 E ROOSEVELT AVE
GRANTS, NM 87020-2245
Phone number: 505-363-5126
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