Provider Demographics
NPI:1841587409
Name:IVES, ALISON M (DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:IVES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:M
Other - Last Name:TULK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5340 ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-4008
Mailing Address - Country:US
Mailing Address - Phone:440-230-1133
Mailing Address - Fax:440-230-9243
Practice Address - Street 1:1 INFINITY CORPORATE CENTRE DR
Practice Address - Street 2:SUITE 160
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-5369
Practice Address - Country:US
Practice Address - Phone:216-587-3310
Practice Address - Fax:216-518-2968
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH008812Medicare PIN
OHH008811Medicare PIN