Graduated: 1994
NPI: 1316010010
Practice Locations (2)
IVYREHAB MICHIGAN LLC
400 ROUNDS DR
FENTON, MI 484301724
8107501996
LAKESIDE COMPREHENSIVE REHABILITATION INC.
601 E MAIN ST
HART, MI 494201144
2318733577
Source: CMS National Downloadable File, September 2026.