Alicia F Lewallen, OT | |
590 Historic Highway 441, Suite E, Demorest, GA 30535-4561 | |
(706) 754-6611 | |
(706) 754-5834 |
Full Name | Alicia F Lewallen |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 590 Historic Highway 441, Demorest, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821190190 | NPI | - | NPPES |
OT001729 | Other | GA | OCCUPATIONAL THERAPY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT1729 (Georgia) | Primary |
Provider Name | Independent Physical Therapy Of Georgia Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1780636068 PECOS PAC ID: 2961312244 Enrollment ID: O20040303000396 |
Mailing Address | Practice Location Address |
---|---|
Alicia F Lewallen, OT 8823 Production Ln, Ooltewah, TN 37363-6511 Ph: (423) 238-7217 | Alicia F Lewallen, OT 590 Historic Highway 441, Suite E, Demorest, GA 30535-4561 Ph: (706) 754-6611 |
Amber Vandiver, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 541 Historic Hwy N, Demorest, GA 30535 Phone: 706-754-3113 | |
Mrs. Dedrika Ashmore Johnson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 541 N. Historic Highway, Demorest, GA 30535 Phone: 706-754-0029 | |
Hannah Rajan, BS., MGA., OTR., CHT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 541 N Historic Highway, Habersham County Medical Center, Demorest, GA 30535 Phone: 706-754-0029 | |
Jennifer Moorhead, MS, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 590 441 Historic Hwy N Ste E, Demorest, GA 30535 Phone: 706-754-6611 |