| Vandalia Physical Therapy Ltd | |
|
126 S. 1st St., Vandalia, IL 62471 | |
| (618) 283-1634 | |
| (618) 283-0423 |
| Full Name | Vandalia Physical Therapy Ltd |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Physical Therapy |
| Location | 126 S. 1st St., Vandalia, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174585384 | NPI | - | NPPES |
| 02621166 | Other | IL | BLUE CROSS BLUE SHIELD |
| 058989 | Other | IL | HEALTH ALLIANCE |
| 135204 | Other | IL | GROUP HEALTH PLAN |
| 331866 | Other | IL | HEALTHLINK |
| 371315508 | Other | IL | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
| Provider Name | Julie M Gordon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952429078 PECOS PAC ID: 2961497987 Enrollment ID: I20040421000190 |
| Provider Name | James Christopher Wilhite |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861911760 PECOS PAC ID: 4486020963 Enrollment ID: I20221025002170 |
| Provider Name | Mattie Rose Carter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922684653 PECOS PAC ID: 6002280716 Enrollment ID: I20230321000715 |
| Provider Name | Shelby Stone |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245037704 PECOS PAC ID: 1153842653 Enrollment ID: I20250312001577 |
| Mailing Address | Practice Location Address |
|---|---|
| Vandalia Physical Therapy Ltd 126 S. 1st St., Vandalia, IL 62471 Ph: (618) 283-1634 | Vandalia Physical Therapy Ltd 126 S. 1st St., Vandalia, IL 62471 Ph: (618) 283-1634 |