Individual
OLIVIA IBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
22507 N 31ST AVE UNIT 13, PHOENIX, AZ 85027-1693
(602) 670-0713
Mailing address
22507 N 31ST AVE UNIT 13, PHOENIX, AZ 85027-1693
(602) 670-0713
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-010895
AZ
Other
Enumeration date
05/21/2024
Last updated
06/30/2024
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