| Doctor Name: | FRANK EDWARD IVAN |
| NPI Number: | 1730485376 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 2305206758 |
| Business Practice Address: | 456 Charles H Dimmock Pkwy #1 Colonial Heights, VA - 238342936 |
| Business Phone Number: | 8045208366 |
| Business Fax Number: | 8045208369 |
| Mailing Address: | 5252 Lyngate Ct, Ste 203 BURKE |
| State: | VA |
| Postal Code: | 220151672 |
| Phone Number: | 7032392300 |
| Fax Number: | 7032392301 |
| NPI Enumeration Date: | 01/30/2011 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305206758 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |