| Trent Harvick, | |
|
1200 N Pecan, Altus, OK 73521-6141 | |
| (580) 379-5820 | |
| Not Available |
| Full Name | Trent Harvick |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1200 N Pecan, Altus, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881045318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5144 (Oklahoma) | Primary |
| Provider Name | Boomer 06 Pllc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1871126383 PECOS PAC ID: 3870924723 Enrollment ID: O20200511000968 |
| Mailing Address | Practice Location Address |
|---|---|
| Trent Harvick, 3221 Northridge Cir, Altus, OK 73521-2356 Ph: () - | Trent Harvick, 1200 N Pecan, Altus, OK 73521-6141 Ph: (580) 379-5820 |
Cynthea Mika My Hosoda Lam, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 Fax: 580-379-5829 | |
Jamie Koeritz, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 | |
Mrs. Susan Elizabeth Spirlock, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 | |
Mr. James Alonzo Patterson, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 301 E Broadway St, Altus, OK 73521 Phone: 580-477-3305 Fax: 580-477-2423 | |
Ms. Kirstie Lea Shive, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 E Broadway St, Altus, OK 73521 Phone: 580-477-3305 Fax: 580-477-2423 | |
Ken Simmons, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1100 Ranch Rd N, Altus, OK 73521 Phone: 580-471-1519 | |
Allison Howard, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 803-795-8205 Fax: 580-379-5829 |