| Marc A Colclasure, PT | |
|
530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | |
| (309) 683-5094 | |
| Not Available |
| Full Name | Marc A Colclasure |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 530 Ne Glen Oak Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811913874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070-011997 (Illinois) | Primary |
| Provider Name | Synergy Family Therapy Specialists Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1508288804 PECOS PAC ID: 6709016777 Enrollment ID: O20140423000956 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc A Colclasure, PT 1700 Thomas Paine Pkwy, Centerville, OH 45459-2541 Ph: (309) 655-2000 | Marc A Colclasure, PT 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 Ph: (309) 683-5094 |
Michelle C Bayer, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2338 W Van Winkle Way, Suite 3100, Peoria, IL 61615 Phone: 309-693-9189 Fax: 309-693-9946 | |
Payton Hufnagel, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-883-5070 | |
Jonathan R Sutter, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-4109 | |
Matthew Schultz, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-621-4111 | |
Molly D Lisenby, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5009 N Executive Dr Ste B, Peoria, IL 61614 Phone: 309-839-8631 Fax: 855-579-3536 | |
Vanessa L Halstead, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 507 E Armstrong Ave, Peoria, IL 61603 Phone: 309-686-1177 Fax: 309-687-2035 | |
Mrs. Theresa L. Snedden, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-692-8110 |