| Keith Franklin Bumgardner Jr, DPT | |
|
849 S Route 51 Ste D, Forsyth, IL 62535-8808 | |
| (217) 872-2244 | |
| Not Available |
| Full Name | Keith Franklin Bumgardner Jr |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 849 S Route 51 Ste D, Forsyth, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598289142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 007133 (Kentucky) | Secondary |
| 225100000X | Physical Therapist | 070.024270 (Illinois) | Primary |
| Provider Name | Midwest Pcw Pt Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1275931156 PECOS PAC ID: 3779807482 Enrollment ID: O20150128000517 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Franklin Bumgardner Jr, DPT 849 S Route 51 Ste D, Forsyth, IL 62535-8808 Ph: (217) 872-2244 | Keith Franklin Bumgardner Jr, DPT 849 S Route 51 Ste D, Forsyth, IL 62535-8808 Ph: (217) 872-2244 |
Ashley Phillips, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 849 S Route 51 Ste D, Forsyth, IL 62535 Phone: 217-872-2244 Fax: 866-394-6713 | |
Midwest Pcw Pt, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 849 S Route 51, Forsyth, IL 62535 Phone: 217-864-2085 Fax: 217-864-2324 | |
Krishna Vaghasia, Physical Therapist Medicare: Medicare Enrolled Practice Location: 565 W Marion Ave, Forsyth, IL 62535 Phone: 217-876-9268 |