NPI 1003655812

Olivia Ibach, PTA

Practitioner Physical Therapy Assistant Phoenix, AZ

Practice location

Address: 22507 N 31st Ave Unit 13, Phoenix, AZ 85027-1693
Phone: (602) 670-0713

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA-010895 (AZ)

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Registry record

NPI: 1003655812
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 May 2024
Record last updated: 30 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.