Mark Kevin Oller Viduya, | |
4249 Highway 411 Ste 4, Madisonville, TN 37354-1544 | |
(423) 442-4034 | |
(423) 442-6463 |
Full Name | Mark Kevin Oller Viduya |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 4249 Highway 411 Ste 4, Madisonville, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407557580 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 012542 (Connecticut) | Primary |
Provider Name | Agilitas Usa Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1962417444 PECOS PAC ID: 3375454648 Enrollment ID: O20041115000337 |
Mailing Address | Practice Location Address |
---|---|
Mark Kevin Oller Viduya, 1580 Sawgrass Corporate Pkwy Ste 200, Sunrise, FL 33323-2869 Ph: (954) 739-4247 | Mark Kevin Oller Viduya, 4249 Highway 411 Ste 4, Madisonville, TN 37354-1544 Ph: (423) 442-4034 |
Lance Hodge, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4249 Highway 411 Ste 4, Madisonville, TN 37354 Phone: 423-442-4034 | |
Michaela Hauer, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4249 Highway 411 Ste 4, Madisonville, TN 37354 Phone: 423-442-4043 | |
Gage Kerns, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4249 Highway 411 Ste 4, Madisonville, TN 37354 Phone: 423-442-4034 | |
Justin Brown, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4249 Highway 411 Ste 4, Madisonville, TN 37354 Phone: 423-442-4034 | |
Zachary John Gerber, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4249 Highway 411, Ste 4, Madisonville, TN 37354 Phone: 423-436-0309 Fax: 423-436-0310 | |
Mrs. Nicole Marie Cresswell, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4249 Highway 411, Ste 4, Madisonville, TN 37354 Phone: 423-436-0309 Fax: 423-436-0310 |