Individual
JACYNDA LEIGH LAVANTURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 ARCADE AVE, SUITE 400, ELKHART, IN 46514-2477
(574) 522-2284
(574) 522-3952
Mailing address
500 ARCADE AVE, SUITE 400, ELKHART, IN 46514-2477
(574) 522-2284
(574) 522-3952
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000900A
IN
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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