Organization
IVYREHAB SEPT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MILES (CFO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
680 KINGSBOROUGH SQ, SUITE B, CHESAPEAKE, VA 23320-4988
(757) 547-0434
(757) 547-0625
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
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/20/2007
Last updated
10/16/2017
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