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General NPI Number Information
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NPI Number | 1922490275
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Entity Type | Individual
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Provider Name | CHERYL L IVES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 702 AUSTIN ST
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City | MIDLAND
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State | TX
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Zip | 79703-5630
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Country | US
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Telephone | 432-664-5263
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 MUSICK RD
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City | TOLAR
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State | TX
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Zip | 76476-2019
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Country | US
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Telephone | 432-664-5263
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1247327
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License Number State | TX
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