Mia Anica Khey Fuentebella, PT | |
812 N Logan Ave, Danville, IL 61832-3752 | |
(217) 443-5000 | |
Not Available |
Full Name | Mia Anica Khey Fuentebella |
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Gender | Female |
Speciality | Physical Therapist |
Location | 812 N Logan Ave, Danville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710558465 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Paxxon Healthcare Services Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1063784148 PECOS PAC ID: 8325959554 Enrollment ID: O20120507000412 |
Mailing Address | Practice Location Address |
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Mia Anica Khey Fuentebella, PT 4510 Nicklaus Dr Apt 105, Champaign, IL 61822-1489 Ph: () - | Mia Anica Khey Fuentebella, PT 812 N Logan Ave, Danville, IL 61832-3752 Ph: (217) 443-5000 |
Mr. Ronnie Lee Day, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3815 N Vermilion St, Danville, IL 61832 Phone: 217-446-7878 Fax: 217-446-7865 | |
Plamen Alexandrov, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1900 E Main St, Danville, IL 61832 Phone: 217-554-5235 | |
Ms. Nancy S. Davidson, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3545 N Vermilion St, Danville, IL 61832 Phone: 217-442-8611 | |
Ms. Karmini S Persaud, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3733 Poolside Dr, Danville, IL 61832 Phone: 217-442-0812 Fax: 217-442-2181 | |
Professional Physical Therapy, Pc Physical Therapist Medicare: Medicare Enrolled Practice Location: 3815 N Vermilion St, Danville, IL 61832 Phone: 217-446-7878 Fax: 217-446-7865 | |
Yiting Du, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 812 N Logan Ave, Danville, IL 61832 Phone: 217-443-5000 | |
Stacey Mitchell, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2 E Main St Ste 102, Danville, IL 61832 Phone: 217-709-9000 Fax: 217-709-9001 |