| Marc Boults, | |
|
602 Vonderburg Dr, Suite 201, Brandon, FL 33511-5900 | |
| (863) 617-9400 | |
| (863) 688-9858 |
| Full Name | Marc Boults |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 602 Vonderburg Dr, Brandon, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033416631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT 26221 (Florida) | Primary |
| Provider Name | Precision Performance Physical Therapy & Rehabilitation Of Florida, Pa |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1861555898 PECOS PAC ID: 3375505704 Enrollment ID: O20041028000721 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Boults, 602 Vonderburg Dr, Suite 201, Brandon, FL 33511-5900 Ph: (863) 617-9400 | Marc Boults, 602 Vonderburg Dr, Suite 201, Brandon, FL 33511-5900 Ph: (863) 617-9400 |
Mr. Ronney Etienne, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 116 E Bloomingdale Ave, Brandon, FL 33511 Phone: 813-655-3342 Fax: 813-653-0894 | |
Jennifer Bishop, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1056 E Brandon Blvd, Brandon, FL 33511 Phone: 813-413-5513 Fax: 813-681-8300 | |
Tracy A Hennemann, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 116 E Bloomingdale Ave, Brandon, FL 33511 Phone: 891-365-5334 Fax: 813-653-0894 | |
Hillary Hixon, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1076 E Brandon Blvd Ste 106, Brandon, FL 33511 Phone: 813-413-5513 | |
Mr. Randall Walter Grossglass, PT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 134 E Bloomingdale Ave, Brandon, FL 33511 Phone: 813-681-1627 Fax: 813-684-1356 | |
Deborah Raplee, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1056 E Brandon Blvd, Brandon, FL 33511 Phone: 813-413-5513 Fax: 813-681-8300 |