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1932109691
IVORY V LARRY
MOUNT VERNON, WA
NPI
1932109691
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA10000273)
Enumeration Date
2005-07-26
Last Update Date
2007-07-08
Business Address
-- IVORY V LARRY PA-C
1500 CONTINENTAL PL
MOUNT VERNON, WA 98273-4105
Phone number: 360-424-7041
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Mailing Address
-- IVORY V LARRY PA-C
1500 CONTINENTAL PL
MOUNT VERNON, WA 98273-4105
Phone number: 360-424-7041
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