Individual
MR. ALEX RANDALL IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
61 MORRIS PL, FT WRIGHT, KY 41011-2733
(859) 628-0803
Mailing address
61 MORRIS PL, FT WRIGHT, KY 41011-2733
(859) 628-0803
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1357
KY
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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