| Bethany Herold, | |
|
1740 Lions Club Rd, Madison, GA 30650-4762 | |
| (706) 342-1667 | |
| Not Available |
| Full Name | Bethany Herold |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1740 Lions Club Rd, Madison, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316796584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT006262 (Georgia) | Primary |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1528419751 PECOS PAC ID: 2163339722 Enrollment ID: O20160830000411 |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1831619337 PECOS PAC ID: 2163339722 Enrollment ID: O20220916001457 |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Herold, 1590 Calls Creek Cir, Watkinsville, GA 30677-2575 Ph: (404) 395-2864 | Bethany Herold, 1740 Lions Club Rd, Madison, GA 30650-4762 Ph: (706) 342-1667 |
Independent Physical Therapy Of Ga, Llc Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1680 Eatonton Rd, Madison, GA 30650 Phone: 706-342-1971 Fax: 706-342-1973 | |
Lori Frost, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1090 Wynbrooke Pl, Madison, GA 30650 Phone: 706-474-1707 |