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General NPI Number Information
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NPI Number | 1962891754
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Entity Type | Individual
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Provider Name | IVY ECKART
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Gender | Female
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 228 POINTER TRL W
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City | VAN BUREN
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State | AR
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Zip | 72956-2266
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Country | US
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Telephone | 888-531-8801
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Fax |
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Provider Business Mailing Address
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Address Line | 1036 HIGHWAY 64 E
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City | ALMA
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State | AR
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Zip | 72921-6807
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Country | US
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Telephone | 479-651-3389
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Fax | 479-474-4044
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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 | 3752
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License Number State | AR
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