| Ms Lacey Wise, PT | |
|
1316 Mt Saint Helens Way Se, Suite B, Castle Rock, WA 98611 | |
| (360) 557-8020 | |
| Not Available |
| Full Name | Ms Lacey Wise |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1316 Mt Saint Helens Way Se, Castle Rock, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154830677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT61342050 (Washington) | Primary |
| Provider Name | Centralia Physical Therapy Inc Ps |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1952666315 PECOS PAC ID: 0648429688 Enrollment ID: O20121005000577 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Lacey Wise, PT 1817 S Market Blvd Ste C, Chehalis, WA 98532-4100 Ph: (360) 996-4410 | Ms Lacey Wise, PT 1316 Mt Saint Helens Way Se, Suite B, Castle Rock, WA 98611 Ph: (360) 557-8020 |
Pt Northwest Of Longview Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 20 Cowlitz, Castle Rock, WA 98611 Phone: 360-274-4550 Fax: 360-274-4548 | |
Robert Joshua Alexander, Physical Therapist Medicare: Medicare Enrolled Practice Location: 51 Cowlitz St W, Castle Rock, WA 98611 Phone: 360-374-4550 | |
Allison Lunday, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 223 Studebaker Spur 1, Castle Rock, WA 98611 Phone: 253-820-1322 | |
Elizabeth Joy Dudenhofer, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 51 Cowlitz St W, Castle Rock, WA 98611 Phone: 360-274-4550 |