| Mallory Ann Doedtman, DPT | |
|
12704 E 1975th Ave, Effingham, IL 62401-6874 | |
| (217) 821-4715 | |
| Not Available |
| Full Name | Mallory Ann Doedtman |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 12704 E 1975th Ave, Effingham, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982042461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070.019727 (Illinois) | Primary |
| Provider Name | Empowerme Rehabilitation Illinois Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
| Provider Name | Empowerme Wellness Kansas City Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
| Mailing Address | Practice Location Address |
|---|---|
| Mallory Ann Doedtman, DPT 12704 E 1975th Ave, Effingham, IL 62401-6874 Ph: (217) 821-4715 | Mallory Ann Doedtman, DPT 12704 E 1975th Ave, Effingham, IL 62401-6874 Ph: (217) 821-4715 |
Linda Ann Ross, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 503 N Maple St., Effingham, IL 62401 Phone: 217-347-1243 Fax: 217-347-1558 | |
Hunter Lynn Harris, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1302 Avenue Of Mid America Ste 4, Effingham, IL 62401 Phone: 217-606-3004 Fax: 217-717-2190 | |
Prorehab Of Illinois, Inc Physical Therapist Medicare: Medicare Enrolled Practice Location: 1302 Avenue Of Mid America Ste 3, Effingham, IL 62401 Phone: 217-606-3004 Fax: 217-717-2190 | |
Mr. Lindell Lee Richards, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 1303 W Evergreen Ave, Effingham, IL 62401 Phone: 217-342-3400 | |
Mary Probst, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 N Maple St, Effingham, IL 62401 Phone: 217-347-1243 | |
Danica Dalmacion, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 204 Greenview Dr Apt 5b, Effingham, IL 62401 Phone: 347-208-1172 | |
Amanda Baker, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 503 N Maple St, Effingham, IL 62401 Phone: 217-347-1243 Fax: 217-347-1558 |