Individual
FRANK EDWARD IVAN III
Active
Individual
FRANK EDWARD IVAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004477
WV
225100000X
Physical Therapist
Primary
2305206758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2307001197
DIRECT ACCESS CERTIFICATION
VA
01
—
K949 - 0077
CAREFIRST
VA
Enumeration date
01/30/2011
Last updated
12/07/2024
Update your record
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