Individual
MR. IVAN IVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3200 S WATER ST, UPMC SPORTS MEDICINE, PITTSBURGH, PA 15203-2307
(412) 432-3770
(412) 432-3774
Mailing address
2855 ESPY AVE, PITTSBURGH, PA 15216-2119
(412) 953-2960
(412) 344-1771
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003999
PA
Other
Enumeration date
03/19/2007
Last updated
08/30/2007
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