Individual
STEPHENIE IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3782 HIGHWAY 95, SUITE 2, BULLHEAD CITY, AZ 86442-8124
(928) 763-0807
Mailing address
3782 HIGHWAY 95, SUITE 2, BULLHEAD CITY, AZ 86442-8124
(928) 763-0807
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11403A
AZ
Other
Enumeration date
06/26/2015
Last updated
04/06/2017
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