IndividualActive
Jerry Ivy, PT
NPI 1093778680 · Physical Therapist · Joseph, OR
Provider details
- NPI number
- 1093778680
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- License
- 2125 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4 S Main St Ste B
Joseph, OR 97846-8434
Phone: (541) 432-1480
Fax: (541) 432-1481
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 355
Enterprise, OR 97828-0355
Registry dates
- Enumerated
- 2006-04-06
- Last updated
- 2020-01-16
- Certified
- 2020-01-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.