| Liberty Venture Group, Llc | |
|
6014 45th St Unit B, Lubbock, TX 79407-3772 | |
| (806) 780-7433 | |
| (806) 780-7434 |
| Full Name | Liberty Venture Group, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 6014 45th St Unit B, Lubbock, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770888406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1061984 (Texas) | Primary |
| 225100000X | Physical Therapist | 2070918 (Texas) | Secondary |
| 225200000X | Physical Therapy Assistant | 2018420 (Texas) | Secondary |
| Provider Name | Bryce Harvey Olson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508890609 PECOS PAC ID: 6305821026 Enrollment ID: I20040727001150 |
| Provider Name | Fnu Sindhuja Gunasekaran |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235762923 PECOS PAC ID: 5092146118 Enrollment ID: I20200505002156 |
| Provider Name | Rijo G Abraham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447862982 PECOS PAC ID: 3375933286 Enrollment ID: I20211208003273 |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Venture Group, Llc 6014 45th St Unit B, Lubbock, TX 79407-3772 Ph: (806) 780-7433 | Liberty Venture Group, Llc 6014 45th St Unit B, Lubbock, TX 79407-3772 Ph: (806) 780-7433 |
Mrs. Liesl Lynn Olson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3223 S Loop 289, Ste 101, Lubbock, TX 79423 Phone: 806-740-3342 Fax: 806-740-3325 | |
Mr. Robert Glenn Roten, LPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 6801 Indiana Ave, Lubbock, TX 79413 Phone: 806-785-7900 Fax: 806-785-7909 | |
Natalie Denise Steadman, ATC, LAT, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4507 7th St, Lubbock, TX 79416 Phone: 806-791-0316 Fax: 806-743-3518 | |
Jennifer Mounce, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4138 19th St, Lubbock, TX 79407 Phone: 806-771-8008 Fax: 806-771-8009 | |
Mr. Shane Edward Haas, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5606 Geneva Ave, Lubbock, TX 79413 Phone: 806-797-3805 Fax: 806-797-0140 | |
Mr. Charles Franklin Berry, PT, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1628 19th St, Lubbock, TX 79401 Phone: 806-766-1172 Fax: 806-766-1286 | |
Jodi Benham, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6202 82nd St, Lubbock, TX 79424 Phone: 806-687-8008 Fax: 806-687-8009 |