Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
PEGGY A IVAN
Active
Individual
PEGGY A IVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004011
MI
225700000X
Massage Therapist
406631-00
MI
Other
Enumeration date
05/26/2006
Last updated
02/09/2012
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