Organization
IVY WELLNESS CARE LLC
Active
Other names
Ivy Wellness Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE BUTLER (NURSE PRACTITIONER)
(215) 264-8104
Entity
Organization
Contact information
Practice address
712 FITZWATERTOWN RD, GLENSIDE, PA 19038-1306
(215) 885-1112
Mailing address
712 FITZWATERTOWN RD, GLENSIDE, PA 19038-1306
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
12/31/2022
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