Provider Demographics
NPI:1912573445
Name:PASSET, ALIVIA ROSE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALIVIA
Middle Name:ROSE
Last Name:PASSET
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:1415 WOODLAND AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3203
Mailing Address - Country:US
Mailing Address - Phone:515-241-8595
Mailing Address - Fax:515-241-4080
Practice Address - Street 1:1200 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1406
Practice Address - Country:US
Practice Address - Phone:515-241-8595
Practice Address - Fax:515-241-4080
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA108916213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist