IVORY V LARRY

MOUNT VERNON, WA
NPI1932109691
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA10000273)
Enumeration Date2005-07-26
Last Update Date2007-07-08
Business Address
-- IVORY V LARRY PA-C
1500 CONTINENTAL PL
MOUNT VERNON, WA 98273-4105
Phone number: 360-424-7041
Mailing Address
-- IVORY V LARRY PA-C
1500 CONTINENTAL PL
MOUNT VERNON, WA 98273-4105
Phone number: 360-424-7041
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