PHILLIP IVY

CHARLESTON, SC
NPI1861670432
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: SC  3462)
Enumeration Date2008-02-06
Last Update Date2020-09-07
Business Address
-- PHILLIP IVY CRNA
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-1414
Mailing Address
-- PHILLIP IVY CRNA
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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