Individual
AUSTIN BROCK VICKREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5819 JUVENE WAY, CINCINNATI, OH 45233-4731
(513) 335-2856
Mailing address
5819 JUVENE WAY, CINCINNATI, OH 45233-4731
(513) 335-2856
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.007606RX
OH
363A00000X
Physician Assistant
Primary
PA3132
KY
Other
Enumeration date
08/15/2022
Last updated
03/23/2023
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