Individual
LISA A. JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435
(307) 754-7257
(307) 754-7217
Mailing address
777 AVE H, POWELL, WY 82435
(307) 754-7257
(307) 754-7217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
877
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42957600
—
WI
Enumeration date
09/30/2006
Last updated
04/03/2015
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