Individual
ELIZABETH MARIE PAVLICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 LINCOLN PARK BLVD STE 100, KETTERING, OH 45429-6410
(937) 222-3118
(937) 222-1436
Mailing address
500 LINCOLN PARK BLVD STE 100, KETTERING, OH 45429-6410
(937) 222-3118
(937) 222-1436
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-007128RX
MEDICAL STATE LICENSE
OH
Enumeration date
01/10/2022
Last updated
01/10/2022
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