Ivy, Jennifer M

Ivy, Jennifer M is an individual health care provider with primary practice located at Trinity Rehab 13 Northtown Dr Suite 110, Jackson MS 39211. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Ivy, Jennifer M can be contacted via phone (601) 206-9195.

Contact Information

Primary practice address
Trinity Rehab 13 Northtown Dr Suite 110 Jackson MS 39211
Phone: (601) 206-9195
Fax: (601) 957-8391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA1655 Mississippi

Profile Details

NPI number 1912190315
LBN Legal business name Ivy, Jennifer M
Credentials LPTA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2007
Last updated Aug 20th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912190315 NPPES
Mississippi MEDICAID 09014160

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