Most Relevant Information
Provider Data
| NPI Number: | 1003416165 |
| Provider Name: | ALEXIS ROSE VAVALA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/28/2020 |
| Last Updated: | 10/24/2022 |
Provider Practice Location
1885 MARKET ST
WARREN
PA
163651277
Practice Location Phone/Fax
| Phone: | 8147231832 |
| Fax: |
Provider Mailing Location
1885 MARKET ST
WARREN
PA
163651277
Provider Mailing Phone/Fax
| Phone: | 8147231832 |
| Fax: |