| Evolution Alternative Physical Therapy & Wellness Studio Llc | |
|
2510 7th Avenue, Altoona, PA 16602-2004 | |
| (814) 944-6535 | |
| (814) 944-6545 |
| Full Name | Evolution Alternative Physical Therapy & Wellness Studio Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 2510 7th Avenue, Altoona, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093736225 | NPI | - | NPPES |
| P00314995 | Other | PA | PALMETTO GBA |
| 103723387-0001 | Medicaid | PA | |
| 0018563450006 | Medicaid | PA | |
| 103712991-0002 | Medicaid | PA | |
| 103712991-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT012999L (Pennsylvania) | Primary |
| Provider Name | Dawn Colette Mcclellan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841253226 PECOS PAC ID: 2466426499 Enrollment ID: I20040824001337 |
| Provider Name | Lindsay C Bainey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801049655 PECOS PAC ID: 6406919687 Enrollment ID: I20090114000472 |
| Provider Name | Nikki Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831320449 PECOS PAC ID: 2365588100 Enrollment ID: I20091007000727 |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Alternative Physical Therapy & Wellness Studio Llc 2510 7th Avenue, Altoona, PA 16602-2004 Ph: (814) 944-6535 | Evolution Alternative Physical Therapy & Wellness Studio Llc 2510 7th Avenue, Altoona, PA 16602-2004 Ph: (814) 944-6535 |
Maria Bolger, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 620 Howard Ave Ste 3, Altoona, PA 16601 Phone: 814-889-2356 | |
Mr. John Kravetz Iii, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1505 9th Ave, Altoona, PA 16602 Phone: 814-949-4050 Fax: 814-940-2026 | |
Miss Erica Lyn Caldwell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 620 Howard Ave, Altoona, PA 16601 Phone: 814-889-2356 Fax: 814-889-3319 | |
Alex Sommers, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2900 Plank Rd Ste 2, Altoona, PA 16601 Phone: 814-949-9500 | |
Andrea Wilk, OT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3120 Pleasant Valley Blvd, Altoona, PA 16602 Phone: 814-949-9500 | |
Dr. Deanna Sue Johnson, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1510 9th Ave, Altoona, PA 16602 Phone: 814-889-3900 |