Zaccariah Desmond Ivy PA

NPI 1407135205 - Physician Assistant - 363A00000X

NPI Details
NPI 1407135205
Gender Male
Enumeration Date 08/10/2011
Last Updated 01/10/2013
Entity Type Individual
Active Over 5 years ago
Practice Location
14000 E ARAPAHOE ROAD
#300
CENTENNIAL CO, 80112-4028, US
Phone (720) 979-0840
Fax (303) 861-4741
Business Location
4900 S. MONACO ST
#210
DENVER CO, 80237-3486, US
Phone (720) 979-0840
Fax (303) 861-4741
Toxanomy
Taxonomy Code 363A00000X
License State Colorado
License Number 3256
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According to our database, Zaccariah Desmond Ivy PA NPI is 1407135205, taxonomy code is 363A00000X and license number is 3256, license state is located at Colorado. Zaccariah Desmond Ivy PA physically located at 14000 E Arapahoe Road, Centennial CO, 80112-4028. NPI Number Zaccariah Desmond Ivy PA has the Individual type.

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1407135205 NPI number is provided on an as is basis without warranty of any kind. 1407135205 is maintained by the National Plan & Provider Enumeration System. The contents of Zaccariah Desmond Ivy PA are for informational purposes only.