Individual
JAVAHN LAMAR IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3535 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3908
(614) 566-5000
Mailing address
1056 WINDING CREEK LN, DELAWARE, OH 43015-7415
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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