| |
245 Wheelhouse Ln Ste 1451, Lake Mary, FL 32746-3696 | |
(407) 878-0507 | |
(844) 904-0880 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 245 Wheelhouse Ln Ste 1451, Lake Mary, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295372662 | NPI | - | NPPES |
103490700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | (* (Not Available)) | Secondary |
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Montana V Ho |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1053703165 PECOS PAC ID: 6204135056 Enrollment ID: I20160428000962 |
Mailing Address | Practice Location Address |
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245 Wheelhouse Ln Ste 1451, Lake Mary, FL 32746-3696 Ph: (407) 878-0507 | 245 Wheelhouse Ln Ste 1451, Lake Mary, FL 32746-3696 Ph: (407) 878-0507 |