Shasta Dawn Vance, OT | |
: 21 Mcbeth Street Greenville, Greenville, SC 29611 | |
(410) 889-0727 | |
(410) 889-0729 |
Full Name | Shasta Dawn Vance |
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Gender | Female |
Speciality | Occupational Therapist |
Location | : 21 Mcbeth Street Greenville, Greenville, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568800415 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 3350 (South Carolina) | Primary |
Provider Name | Legacy Healthcare Services Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1366063000 PECOS PAC ID: 2163339722 Enrollment ID: O20200629001631 |
Mailing Address | Practice Location Address |
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Shasta Dawn Vance, OT 416 E 30th St, Baltimore, MD 21218-3934 Ph: (410) 889-0727 | Shasta Dawn Vance, OT : 21 Mcbeth Street Greenville, Greenville, SC 29611 Ph: (410) 889-0727 |
Martha Manieri, OTRL Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 534 Old Howell Rd, Greenville, SC 29615 Phone: 864-244-3626 Fax: 864-244-6923 | |
Rebecca Grace Gratton, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 29 N Academy St, Greenville, SC 29601 Phone: 864-331-1353 Fax: 864-331-1446 | |
Shannon Jones, OT/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 536 Old Howell Rd, Greenville, SC 29615 Phone: 864-244-3626 | |
Jami Trenor, OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 11 East Augusta Place, Greenville, SC 29605 Phone: 864-991-8379 | |
Mrs. Kelly Macintire Prater, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 29 N Academy St, Greenville, SC 29601 Phone: 864-331-1364 | |
Ginnette Malay-romkey, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 29 N Academy St, Greenville, SC 29601 Phone: 864-331-1350 | |
Jocelyn R Keefer, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 29 N Academy St, Greenville, SC 29601 Phone: 864-331-1350 |