| Jessica Song, | |
|
1828 E Florence Blvd Ste 102, Casa Grande, AZ 85122-4783 | |
| (502) 510-0360 | |
| Not Available |
| Full Name | Jessica Song |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1828 E Florence Blvd Ste 102, Casa Grande, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326776477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | LPT-32121 (Arizona) | Primary |
| Provider Name | Foothills Sports Medicine & Rehabilitation Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558318170 PECOS PAC ID: 2668457979 Enrollment ID: O20040621001886 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Song, 23374 W Yuma Rd Ste 104, Buckeye, AZ 85326-3120 Ph: () - | Jessica Song, 1828 E Florence Blvd Ste 102, Casa Grande, AZ 85122-4783 Ph: (502) 510-0360 |
Alison Mantel, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 440 N Camino Mercado, Casa Grande, AZ 85122 Phone: 520-836-7996 | |
Kyle Flood, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 580 N Camino Mercado Ste 25, Casa Grande, AZ 85122 Phone: 855-331-7522 | |
Isaac A Houtkooper, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1828 E Florence Blvd, Casa Grande, AZ 85122 Phone: 520-510-0360 | |
Megan L Placencia, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1828 E Florence Blvd Ste 102, Casa Grande, AZ 85122 Phone: 520-510-0360 Fax: 520-858-0174 | |
Dexter Takura Kombo, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1828 E Florence Blvd Ste 102, Casa Grande, AZ 85122 Phone: 520-510-0360 | |
Dave Harish Topiwala, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 440 N Camino Mercado, Casa Grande, AZ 85122 Phone: 520-836-7996 | |
Ari David Goldstein, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1295 E Florence Blvd Ste 1-3, Casa Grande, AZ 85122 Phone: 520-494-3058 Fax: 520-214-5059 |