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Individual

RICHARD D IVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.T.

Contact information

Practice address
335 BILLINGSLEY RD, CHARLOTTE, NC 28211-1040
(704) 335-1911
(704) 343-0811
Mailing address
335 BILLINGSLEY RD, CHARLOTTE, NC 28211-1040
(704) 335-1911
(704) 343-0811

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5452
NC

Other

Enumeration date
04/10/2006
Last updated
07/08/2007
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