| Emporia Myofascial Care3 | |
|
2522 W 15th Ave, Emporia, KS 66801-6102 | |
| (620) 803-2097 | |
| Not Available |
| Full Name | Emporia Myofascial Care3 |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 2522 W 15th Ave, Emporia, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306569660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| Provider Name | Mark Andrew Dejesus |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225249642 PECOS PAC ID: 1557738408 Enrollment ID: I20221104002396 |
| Mailing Address | Practice Location Address |
|---|---|
| Emporia Myofascial Care3 2522 W 15th Ave, Emporia, KS 66801-6102 Ph: (620) 803-2097 | Emporia Myofascial Care3 2522 W 15th Ave, Emporia, KS 66801-6102 Ph: (620) 803-2097 |
Jennifer Kathleen Sakovitz, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 Industrial Rd, Emporia, KS 66801 Phone: 913-940-8612 | |
Brenda Lee, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1201 W 12th Ave, Emporia, KS 66801 Phone: 620-343-6800 Fax: 620-340-6187 | |
Mr. Mark Dejesus, O.T. Occupational Therapist Medicare: Medicare Enrolled Practice Location: 623 Commercial St, Emporia, KS 66801 Phone: 620-803-1855 Fax: 620-208-4488 | |
Miss Janice Leann Cook, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1201 W 12th Ave, Emporia, KS 66801 Phone: 620-343-6800 | |
Ms. Julia L Gotchall, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1201 W 12th Ave, Emporia, KS 66801 Phone: 620-343-6800 | |
Tina Michelle Hauff, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 15 State St, Emporia, KS 66801 Phone: 620-343-2693 |