| Nicole Seal, | |
|
1470 Ne 3rd St, Prineville, OR 97754-2906 | |
| (541) 447-6846 | |
| (541) 447-1243 |
| Full Name | Nicole Seal |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1470 Ne 3rd St, Prineville, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073398749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 65084 (Oregon) | Primary |
| Provider Name | New Proactive Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1396273199 PECOS PAC ID: 7315218708 Enrollment ID: O20170901001937 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Seal, 1650 Lyndon Farm Ct Ste 300, Louisville, KY 40223-5005 Ph: (334) 231-5364 | Nicole Seal, 1470 Ne 3rd St, Prineville, OR 97754-2906 Ph: (541) 447-6846 |
Austin Harrison Fleming, DPT, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1590 Ne 3rd St Ste B, Prineville, OR 97754 Phone: 541-416-7476 Fax: 541-416-7478 | |
Mr. Kenneth W Smith, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1251 Ne Elm St, Ste 2-a, Prineville, OR 97754 Phone: 541-447-6846 Fax: 541-447-1243 | |
Kelsee Sofich, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1470 Ne 3rd St, Prineville, OR 97754 Phone: 541-447-6846 | |
Kenneth W Smith Pt Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1251 Ne Elm St Ste 2a, Prineville, OR 97754 Phone: 541-447-6846 Fax: 541-447-1243 | |
Sarah L Tonna, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 425 N Main St, Prineville, OR 97754 Phone: 541-416-7476 Fax: 541-416-7478 | |
Tamara M Weber, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 425 N Main St, Prineville, OR 97754 Phone: 541-416-7476 Fax: 541-416-7478 |