Jonathon Michael Lavalley, PA-C

NPI #1871915702 in Grants, New Mexico

Provider Information

NPI Number: 1871915702
Entity Type: Individual
Name: Jonathon Michael Lavalley, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 12, 2014
Last Updated: Jan 12, 2014

Practice Location

Address: 1423 E ROOSEVELT AVE
City: Grants
State: New Mexico
ZIP Code: 87020-2245
Phone: (505) 287-6500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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