Marisa Mccormack, | |
4 9th Ave Bldg C, Shalimar, FL 32579-1746 | |
(850) 613-4099 | |
Not Available |
Full Name | Marisa Mccormack |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 4 9th Ave Bldg C, Shalimar, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730705518 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT302271 (California) | Secondary |
225100000X | Physical Therapist | PT35820 (Florida) | Primary |
Provider Name | Physical Therapy West |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1801235759 PECOS PAC ID: 7719113224 Enrollment ID: O20131111000997 |
Mailing Address | Practice Location Address |
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Marisa Mccormack, 574 N Knight Dr, Edwards, CA 93523-2735 Ph: () - | Marisa Mccormack, 4 9th Ave Bldg C, Shalimar, FL 32579-1746 Ph: (850) 613-4099 |
Krista L Evans, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 104 Hands Cove Ln, Shalimar, FL 32579 Phone: 210-471-8375 | |
Amy R Davis, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 Hawthorn House Dr, Shalimar, FL 32579 Phone: 850-609-2550 | |
Michael Travers, Physical Therapist Medicare: Medicare Enrolled Practice Location: 4 9th Ave Ste G, Shalimar, FL 32579 Phone: 205-919-9349 | |
Pro Vita Physical Therapy - Shalimar Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4 9th Ave Ste G, Shalimar, FL 32579 Phone: 850-613-4099 Fax: 855-978-1838 |