Individual
DR. ANTOINETTE LEE LAVALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2658 W. LASKEY ROAD, 2ND FLOOR, TOLEDO, OH 43613-3288
(419) 473-8105
(419) 254-2121
Mailing address
3455 MILL RUN DRIVE, SUITE 450, HILLIARD, OH 43026-9083
(614) 771-2222
(614) 771-2221
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
35052406
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0711108
—
OH
01
—
35052406
LICENSE NUMBER
OH
05
—
711108
—
OH
Enumeration date
01/15/2006
Last updated
03/25/2010
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