Individual
MR. PETER E IVES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
1000 YALE AVE, WALLINGFORD, CT 06492-1838
(203) 294-0449
Mailing address
718 BROAD ST, UNIT B6, MERIDEN, CT 06450-4371
(203) 639-8556
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000208
CT
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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