Individual
IVY MCENTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMP
Contact information
Practice address
3519 PELHAM RD, GREENVILLE, SC 29615-4181
(864) 205-9029
Mailing address
101 BANKSIDE LN, GREENVILLE, SC 29609-1470
(864) 205-9029
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6088
SC
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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