Organization
IVYREHAB NORTHERN PT, LLC
Active
Other names
Ivyrehab Northern PT LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUCKER (CEO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
138 W HIGHLAND RD, HOWELL, MI 48843-2168
(517) 376-4831
(517) 376-4833
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/20/2020
Last updated
08/12/2022
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