Organization
IVYREHAB NORTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUCKER (CEO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
9216 ARDEY KELL ROAD, STE 300, CHARLOTTE, NC 28277-4954
(980) 556-7330
(980) 939-8215
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 824-9219
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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