Organization
IVYREHAB NORTHERN PT, LLC
Active
Organization
IVYREHAB NORTHERN PT, LLC
Active
Other names
Northern Physical Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RUCKER (CEO)
(914) 777-8700
Entity
Organization
Contact information
Practice address
31 IDA RED AVE, SPARTA, MI 49345-1277
(616) 887-8152
(616) 887-3809
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2005
Last updated
08/12/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up