Ivory V Larry, PA-C

NPI #1932109691 in Mount Vernon, Washington

Provider Information

NPI Number: 1932109691
Entity Type: Individual
Name: Ivory V Larry, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 26, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1500 CONTINENTAL PL
City: Mount Vernon
State: Washington
ZIP Code: 98273-4105
Phone: (360) 424-7041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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