Organization
IVYREHAB SEPT, LLC
Active
Other names
SPECTRUM PHYSICAL THERAPY & SOUTHEASTERN THERAPY FOR KIDS
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MILES (EVP & CFO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
3253 TAYLOR RD STE 200, CHESAPEAKE, VA 23321-2452
(757) 881-1138
Mailing address
4668 PEMBROKE BLVD STE 115, VIRGINIA BEACH, VA 23455-6423
(757) 932-4261
(757) 579-8690
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/22/2018
Last updated
09/14/2018
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