Provider Demographics
NPI:1851182406
Name:IVEY, BETHANY LYNN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:LYNN
Last Name:IVEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 S BROAD ST APT 207
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769-7451
Mailing Address - Country:US
Mailing Address - Phone:601-520-5317
Mailing Address - Fax:
Practice Address - Street 1:24500 JOHN T REID PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2326
Practice Address - Country:US
Practice Address - Phone:256-999-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH12280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist