| Olcott Spine Institute Incorporated | |
|
113 W Lemon Street, Lady Lake, FL 32159-3855 | |
| (352) 633-1048 | |
| (352) 633-5274 |
| Full Name | Olcott Spine Institute Incorporated |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 113 W Lemon Street, Lady Lake, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003291469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH10420 (Florida) | Primary |
| Provider Name | Joshua L Olcott |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912148354 PECOS PAC ID: 3375697139 Enrollment ID: I20111214000813 |
| Mailing Address | Practice Location Address |
|---|---|
| Olcott Spine Institute Incorporated 113 W Lemon Street, Lady Lake, FL 32159 Ph: (352) 633-1048 | Olcott Spine Institute Incorporated 113 W Lemon Street, Lady Lake, FL 32159-3855 Ph: (352) 633-1048 |
Dr. Ronald Budd Moussette Jr., DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 712 S Us Highway 441, Lady Lake, FL 32159 Phone: 352-750-5310 Fax: 352-259-0734 | |
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