Individual
AMANDA IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
963 W YELLOWJACKET LN, ROCKWALL, TX 75087-4950
(866) 584-7117
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-5086
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2109018
TX
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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