Individual
MR. MATTHEW J SHIVERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
939 ANGULAR ST, BURLINGTON, IA 52601-3918
(319) 753-0112
Mailing address
3112 406TH RD, WEST BURLINGTON, IA 52655-9607
(319) 754-6855
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15336
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012286
—
IA
Enumeration date
04/14/2006
Last updated
07/09/2007
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