Individual
WILLIAM DAVID IVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., ATC
Contact information
Practice address
220 ASSOCIATES BLVD, ALCOA, TN 37701-1943
(865) 980-7140
Mailing address
3250 SEVIERVILLE RD, MARYVILLE, TN 37804-2303
(865) 789-4523
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1293
TN
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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