Organization
IVYREHAB SEPT, LLC
Active
Other names
Southeastern Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MILES (EVP & CFO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
801 POINDEXTER STREET, SUITE 219, CHESAPEAKE, VA 23324
(757) 548-0014
(757) 351-1930
Mailing address
5301 PROVIDENCE RD, SUITE 80, VIRGINIA BEACH, VA 23464-4128
(757) 467-1900
(757) 467-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305006769
VA
Other
Enumeration date
11/06/2009
Last updated
11/20/2017
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