Diana Ivkovich, AT
Specialist/Technologist, Athletic Trainer in Fairfield, OH. Individual provider (NPI-1).
NPI number1710313325
StatusActive
Last updated in NPPESSep 16, 2013
Details
- NPI
- 1710313325
- Entity type
- Individual (NPI-1)
- Name
- Diana Ivkovich
- Credential
- AT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2013
- Last updated
- Sep 16, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT000539 | OH | Yes |
Practice location
5402 Hannah View DrFairfield, OH 45014-3927
Phone 513-939-1570
Mailing address
5402 Hannah View DrFairfield, OH 45014-3927
Phone 513-939-1570
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