| Mrs Lisa Leanne Gentzler, MPT | |
|
1319 E King Ave, Kingsland, GA 31548-6831 | |
| (404) 351-5307 | |
| (404) 351-5308 |
| Full Name | Mrs Lisa Leanne Gentzler |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1319 E King Ave, Kingsland, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093898991 | NPI | - | NPPES |
| 313800 | Other | WY | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT016970 (Georgia) | Primary |
| 225100000X | Physical Therapist | PT 1072 (Wyoming) | Secondary |
| Provider Name | Sports Medicine And Rehab Therapy Camden |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1821796145 PECOS PAC ID: 9537534318 Enrollment ID: O20230410000178 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lisa Leanne Gentzler, MPT 5307 Yellowstone Rd, Cheyenne, WY 82009-4736 Ph: (307) 632-7677 | Mrs Lisa Leanne Gentzler, MPT 1319 E King Ave, Kingsland, GA 31548-6831 Ph: (404) 351-5307 |
Mrs. Marisa G Harvey, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1204 Hospitality Ave Ste E, Kingsland, GA 31548 Phone: 912-996-2069 Fax: 912-265-0041 | |
Allyson M Sunderman, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Hunter Beck, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1390 Boone Avenue Ext Ste 23, Kingsland, GA 31548 Phone: 912-319-0400 | |
Robert A Richards, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln, Suite A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Chad Nolan Oakley, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 | |
Michael J Janusko, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln # A, Kingsland, GA 31548 Phone: 912-729-1333 Fax: 912-729-5259 |