Madison Misenheimer, OTR/L | |
263 E Broadway Blvd, Jefferson City, TN 37760-2810 | |
(865) 375-0880 | |
(423) 317-7773 |
Full Name | Madison Misenheimer |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 263 E Broadway Blvd, Jefferson City, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790407104 | NPI | - | NPPES |
7416 | Other | TN | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 7416 (Tennessee) | Primary |
Provider Name | Jordan C Black |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1528569316 PECOS PAC ID: 5890117469 Enrollment ID: O20200629000595 |
Mailing Address | Practice Location Address |
---|---|
Madison Misenheimer, OTR/L 325 W Morris Blvd Ste B, Morristown, TN 37813-2237 Ph: (423) 375-8907 | Madison Misenheimer, OTR/L 263 E Broadway Blvd, Jefferson City, TN 37760-2810 Ph: (865) 375-0880 |
Mrs. Twana Elaine Mullins, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 710 W Ellis St, Jefferson City, TN 37760 Phone: 423-312-5181 | |
Lauren Williams, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 283 W Broadway Blvd, Jefferson City, TN 37760 Phone: 865-475-9037 | |
Independant Physical Therapy Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 646 E Broadway Blvd, Jefferson City, TN 37760 Phone: 865-471-6890 Fax: 865-475-0847 |