Individual
ALLYSSA JAYE LIVOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 930-2130
Mailing address
1372 BARRON LAKE RD, NILES, MI 49120-9355
(269) 930-2130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012395
MI
Other
Enumeration date
04/26/2024
Last updated
08/04/2024
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