Individual
IVY TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 KEISLER DR, STE. 101, CARY, NC 27518-7084
(919) 378-1492
Mailing address
444 S BLOUNT ST, STE. 119, RALEIGH, NC 27601-1881
(704) 607-2664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NC
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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