Organization
IRL REHAB GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVY KERNS PT (MEMBER/ PHYSICAL THERAPIST)
(812) 887-9484
Entity
Organization
Contact information
Practice address
325 N GIBSON ST, PRINCETON, IN 47670-1813
(812) 887-9484
Mailing address
1071 N BICKNELL RD, WHEATLAND, IN 47597-8124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007933A
IN
Other
Enumeration date
03/08/2010
Last updated
06/07/2010
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