Individual
EFFIE E LARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
210 E GRAY ST STE 1105, LOUISVILLE, KY 40202-3907
(502) 583-1697
(919) 385-9353
Mailing address
200 TRENT DR # 1B1C, DURHAM, NC 27710-8568
(919) 684-7777
(919) 385-9353
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110007853
VA
363A00000X
Physician Assistant
PA9102536
FL
363A00000X
Physician Assistant
Primary
TC079
KY
Other
Enumeration date
02/23/2006
Last updated
11/30/2023
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