Mr Daryl L Ivins, PT | |
4132 Devonshire Ct Ne, Salem, OR 97305-1982 | |
(503) 371-4800 | |
(503) 371-4801 |
Full Name | Mr Daryl L Ivins |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 26 Years |
Location | 4132 Devonshire Ct Ne, Salem, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316007636 | NPI | - | NPPES |
11-3708203 | Other | OR | HEALTHNET |
831552000 | Other | OR | BLUE CROSS PPP |
J 2333-01 | Other | OR | PACIFICSOURCE |
113708203 | Other | OR | LIFEWISE |
500113701 | Other | OR | BLUE CROSS - ACCESS BLUE |
500113701 | Other | OR | FIRST CHOICE 65 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 3584 (Oregon) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Promotion Advanced Functional Rehab Llc | 1759391394 | 9 |
Provider Name | Promotion Advanced Functional Rehab Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1710932710 PECOS PAC ID: 1759391394 Enrollment ID: O20060427000203 |
Mailing Address | Practice Location Address |
---|---|
Mr Daryl L Ivins, PT 4132 Devonshire Ct Ne, Salem, OR 97305-1982 Ph: (503) 371-4800 | Mr Daryl L Ivins, PT 4132 Devonshire Ct Ne, Salem, OR 97305-1982 Ph: (503) 371-4800 |
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