| NPI | 1730467507 |
|---|---|
| Former Name | IVY LYNN DEVITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014531) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 25629) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2020-05-14 |