Christine Banas Soriano, | |
4407 Amarillo St, Blytheville, AR 72315-5702 | |
(870) 532-2229 | |
(870) 532-8237 |
Full Name | Christine Banas Soriano |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 4407 Amarillo St, Blytheville, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376651612 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OTR 1812 (Arkansas) | Primary |
Provider Name | Legacy Healthcare Services Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1336770221 PECOS PAC ID: 2163339722 Enrollment ID: O20200305001210 |
Mailing Address | Practice Location Address |
---|---|
Christine Banas Soriano, 27575 N Silverado Ranch Rd, Peoria, AZ 85383-8819 Ph: (480) 823-9291 | Christine Banas Soriano, 4407 Amarillo St, Blytheville, AR 72315-5702 Ph: (870) 532-2229 |
Justino Mario C Dublois, Jr., Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4407 Amarillo St, Blytheville, AR 72315 Phone: 870-532-2229 | |
Sinu K George, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4407 Amarillo St, Blytheville, AR 72315 Phone: 870-532-2229 | |
Ma Cedeno, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4407 Amarillo Street, Blytheville, AR 72315 Phone: 870-532-2229 Fax: 870-532-8237 | |
Michelle N Baum, OTR Occupational Therapist Medicare: Medicare Enrolled Practice Location: 4407 Amarillo St, Blytheville, AR 72315 Phone: 870-532-2229 |