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Individual

ANTHONY MCGILLVARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2411 W STATE ROUTE 571, TIPP CITY, OH 45371-9673
(937) 418-2576
Mailing address
2411 W STATE ROUTE 571, TIPP CITY, OH 45371-9673
(937) 418-2576

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0167799
OH
Enumeration date
11/30/2020
Last updated
11/30/2020
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