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Individual

LEVI INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2312 S DIXON RD STE 250, KOKOMO, IN 46902-6426
(765) 459-7275
(800) 805-4620
Mailing address
931 LIVE OAK CT, KOKOMO, IN 46901-0701
(765) 210-4899

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001851A
IN

Other

Enumeration date
04/10/2023
Last updated
04/10/2023
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