Individual
VAN E LAMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3338
(907) 456-3443
Mailing address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3338
(907) 456-3443
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
004580
MI
363AS0400X
Surgical Physician Assistant
004580
MI
363AS0400X
Surgical Physician Assistant
10001088A
IN
363AS0400X
Surgical Physician Assistant
Primary
PADA631
AK
Other
Enumeration date
05/12/2006
Last updated
10/04/2019
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