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Individual

AMY ELIZABETH VILAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
4071 24TH AVE, FORT GRATIOT, MI 48059-3801
(810) 824-4222
(810) 824-4220
Mailing address
4071 24TH AVE, FORT GRATIOT, MI 48059-3801
(810) 824-4222
(810) 824-4220

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005564
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1598090797
MI
Enumeration date
10/06/2009
Last updated
11/23/2016
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