| Vincent John R Busante, | |
|
247 S Main St, Reidsville, GA 30453-4605 | |
| (912) 557-1000 | |
| Not Available |
| Full Name | Vincent John R Busante |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 247 S Main St, Reidsville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558979591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT007769 (Georgia) | Primary |
| Provider Name | Optim Orthopedics Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780077982 PECOS PAC ID: 9931427002 Enrollment ID: O20150429001342 |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent John R Busante, 2200 Old Quacco Rd # Atp5204, Pooler, GA 31322-0558 Ph: (757) 515-9110 | Vincent John R Busante, 247 S Main St, Reidsville, GA 30453-4605 Ph: (912) 557-1000 |
Rebekah Hollis Parker, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 247 A South Main Street, Reidsville, GA 30453 Phone: 912-557-8990 Fax: 912-557-8980 | |
Chasity Carter Mcneal, OCCUPATION THERAPIST Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 247 S Main St, Reidsville, GA 30453 Phone: 912-557-1000 Fax: 912-557-1009 | |
Mrs. Ashley Nicole Vaughan, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 247 S Main St, Reidsville, GA 30453 Phone: 912-557-1000 Fax: 912-557-1009 |