Larissa Sorrells, | |
400 E 4th St, Beardstown, IL 62618-1307 | |
(217) 248-5795 | |
Not Available |
Full Name | Larissa Sorrells |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 400 E 4th St, Beardstown, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427300870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 070019416 (Illinois) | Primary |
225X00000X | Occupational Therapist | 056009166 (Illinois) | Secondary |
Provider Name | Beardstown Therapy Clinic |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1700596442 PECOS PAC ID: 6507223989 Enrollment ID: O20230530001670 |
Mailing Address | Practice Location Address |
---|---|
Larissa Sorrells, 21 North Dr, Beardstown, IL 62618-4400 Ph: (217) 248-5795 | Larissa Sorrells, 400 E 4th St, Beardstown, IL 62618-1307 Ph: (217) 248-5795 |
Mr. Keith David Schroeder, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 E 4th St, Beardstown, IL 62618 Phone: 217-323-7006 | |
Addison Paige Lagemann, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8 Walker Ave, Beardstown, IL 62618 Phone: 217-320-9939 | |
Caitlin Mahoney, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 E 4th St, Beardstown, IL 62618 Phone: 217-323-7006 |