Individual
CHRISTOPHER JAMES IVANIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
64 BLUFFTON RD, BLUFFTON, SC 29910-7621
(843) 681-2376
Mailing address
PO BOX 749303, ATLANTA, GA 30374-9303
(843) 681-2376
(843) 757-3269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9916
SC
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01226971
MEDICARE RAILROAD
IL
Enumeration date
07/11/2012
Last updated
02/11/2025
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