Doctor Name: | KEVIN DALE IVEY |
NPI Number: | 1962596908 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 20829 |
Business Practice Address: | 565 Brunswick Rd Suite 4 Grass Valley, CA - 959459529 |
Business Phone Number: | 5302734152 |
Business Fax Number: | 5302734153 |
Mailing Address: | 565 Brunswick Rd, Suite 4 GRASS VALLEY |
State: | CA |
Postal Code: | 959459529 |
Phone Number: | 5302734152 |
Fax Number: | 5302734153 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 05/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 20829 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |