Individual
AMY M IVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.T.A.
Contact information
Practice address
236 BURTS RD, KIRKWOOD, NY 13795-1731
(877) 426-3307
Mailing address
606 BARNES AVE, ENDICOTT, NY 13760-4121
(607) 759-1386
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005671
NY
Other
Enumeration date
10/05/2010
Last updated
03/17/2018
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