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Individual

ELIZABETH ANN IVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.T.

Contact information

Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8700
Mailing address
2119 HOUSTON AVE, STOCKTON, CA 95206-4772
(209) 401-5299

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary
34241
CA

Other

Enumeration date
05/27/2008
Last updated
05/27/2008
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