Most Relevant Information
Provider Data
| NPI Number: | 1003292079 |
| Provider Name: | MICHELLE IVERY |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 398412 |
Most Important Dates
| Enumeration Date: | 07/31/2015 |
| Last Updated: | 07/31/2015 |
Provider Practice Location
318 HOLLENCAMP AVE
DAYTON
OH
454179029
Practice Location Phone/Fax
| Phone: | 9373970334 |
| Fax: |
Provider Mailing Location
318 HOLLENCAMP AVE
DAYTON
OH
454179029
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |