Kathryn Theisen, | |
5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311 | |
(800) 330-7711 | |
(386) 944-7202 |
Full Name | Kathryn Theisen |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 5535 S Williamson Blvd, Port Orange, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316360720 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 20430 (Massachusetts) | Primary |
Provider Name | Provencher Physical Therapy, Inc. |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1225358310 PECOS PAC ID: 8729273925 Enrollment ID: O20150501000097 |
Mailing Address | Practice Location Address |
---|---|
Kathryn Theisen, 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311 Ph: (800) 330-7711 | Kathryn Theisen, 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311 Ph: (800) 330-7711 |
Erin Kwiatkowski, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5535 S Williamson Blvd, Port Orange, FL 32128 Phone: 888-265-2680 | |
Mr. Jack Verhees, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4904 S Clyde Morris Blvd, Ste D2, Port Orange, FL 32129 Phone: 386-898-0908 Fax: 386-898-0242 | |
Amanda Owen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128 Phone: 386-756-4395 Fax: 386-944-7202 | |
Megan Christiansen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128 Phone: 800-330-7711 | |
Spencer Swift, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128 Phone: 386-756-4395 Fax: 386-944-7202 | |
Ratree Lertkitcharoenpon, PT,DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4649 Clyde Morris Blvd Unit 607, Port Orange, FL 32129 Phone: 386-256-3860 | |
Lee Ann Magiera, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5535 S Williamson Blvd Ste 774, Port Orange, FL 32128 Phone: 888-265-2680 |