Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivyrehab Michigan, LLC

Organization Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1104337120

Ivyrehab Michigan, LLC is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Fenton, Michigan. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

400 Rounds Dr
Fenton, MI 48430-1724
Phone: (810) 750-1996
Fax: (810) 750-6361
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X

Record details

NPI number1104337120
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Griffiths — Sr. Director Of Provider Relations · (914) 294-4050
NPI enumeratedOctober 17, 2017
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025
Mailing address1311 Mamaroneck Ave Ste 140, White Plains, NY 10605-5224