Provider Demographics
NPI:1962891754
Name:ECKART, IVY
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:
Last Name:ECKART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 HIGHWAY 64 E
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-6807
Mailing Address - Country:US
Mailing Address - Phone:479-651-3389
Mailing Address - Fax:479-474-4044
Practice Address - Street 1:228 POINTER TRL W
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2266
Practice Address - Country:US
Practice Address - Phone:888-531-8801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist