Individual
AMY MARIE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(248) 872-2151
Mailing address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009605
MI
Other
Enumeration date
10/02/2019
Last updated
01/05/2023
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