Individual
ASHLY ALEESE OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
212 S SULLIVAN AVE, FREMONT, MI 49412-1548
(616) 391-3139
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013668
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
5601013668
MI
Other
Enumeration date
12/04/2025
Last updated
02/09/2026
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