Individual
MICHELLE ELISE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
4621 EASTPARK BLVD, MADISON, WI 53718-2000
(608) 916-1100
Mailing address
4621 EASTPARK BLVD, MADISON, WI 53718-2000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16904-24
WI
225100000X
Physical Therapist
Primary
62762
OR
Other
Enumeration date
05/24/2018
Last updated
02/24/2026
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