Lucie Marie Stagg, DPT | |
400 4th Ave S Apt 106, St Petersburg, FL 33701-4621 | |
(571) 289-9595 | |
Not Available |
Full Name | Lucie Marie Stagg |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 400 4th Ave S Apt 106, St Petersburg, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255910592 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT36008 (Florida) | Primary |
Provider Name | Elder Athlete Physical Therapy Pllc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1841944519 PECOS PAC ID: 0547654998 Enrollment ID: O20221208002059 |
Mailing Address | Practice Location Address |
---|---|
Lucie Marie Stagg, DPT 400 4th Ave S Apt 106, St Petersburg, FL 33701-4621 Ph: (571) 289-9595 | Lucie Marie Stagg, DPT 400 4th Ave S Apt 106, St Petersburg, FL 33701-4621 Ph: (571) 289-9595 |
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