| Dv Therapy Inc. | |
|
1080 S La Cienega Blvd Ste 208 Los Angeles CA 90035-2680 | |
| (323) 426-6402 | |
| (323) 714-0112 |
| Full Name | Dv Therapy Inc. |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | 1080 S La Cienega Blvd Ste 208, Los Angeles, California |
| Authorized Official Name and Position | Iddo Devries (OWNER) |
| Authorized Official Contact | 3234266402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dv Therapy Inc. 1080 S La Cienega Blvd Ste 208 Los Angeles CA 90035-2680 Ph: (323) 426-6402 | Dv Therapy Inc. 1080 S La Cienega Blvd Ste 208 Los Angeles CA 90035-2680 Ph: (323) 426-6402 |
| NPI Number | 1518363597 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 10/23/2019 |
| Medicare PECOS PAC ID | 8022343326 |
|---|---|
| Medicare Enrollment ID | O20190709001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518363597 | NPI | - | NPPES |
| Provider Name | Iddo Devries |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649402785 PECOS PAC ID: 7113252420 Enrollment ID: I20191003000004 |
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