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
5960 FAIRVIEW RD, CHARLOTTE, NC 28210-3102
(980) 224-7958
(980) 224-7973
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
(631) 580-5200
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
08/12/2022
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