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General NPI Number Information
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NPI Number | 1225835630
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Entity Type | Individual
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Provider Name | JORDYN IVEY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1451 BLUESTEM BLVD STE E
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City | ALTOONA
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State | WI
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Zip | 54720-2619
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Country | US
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Telephone | 715-727-5621
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Fax |
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Provider Business Mailing Address
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Address Line | 220 LAMANS LN
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5988
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Country | US
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Telephone | 715-590-2186
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 8830-26
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License Number State | WI
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