| Mark Probasco, DPT | |
|
130 Marvin Rd Se Ste 203, Lacey, WA 98503-6101 | |
| (360) 456-3300 | |
| (360) 456-6060 |
| Full Name | Mark Probasco |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 130 Marvin Rd Se Ste 203, Lacey, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356709190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 15209 (Wisconsin) | Primary |
| Provider Name | Marshfield Clinic Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1952347981 PECOS PAC ID: 2264345206 Enrollment ID: O20031106000590 |
| Provider Name | Beaver Dam Community Hospitals Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1972188555 PECOS PAC ID: 2567370539 Enrollment ID: O20040210000666 |
| Provider Name | Memorial Hospital Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1346239373 PECOS PAC ID: 2365433224 Enrollment ID: O20040519001426 |
| Provider Name | Flambeau Hospital, Inc. |
|---|---|
| Provider Type | Part A Provider - Critical Access Hospital |
| Provider Identifiers | NPI Number: 1700963048 PECOS PAC ID: 9032029871 Enrollment ID: O20070828000478 |
| Provider Name | Memorial Hospital Inc |
|---|---|
| Provider Type | Part A Provider - Critical Access Hospital |
| Provider Identifiers | NPI Number: 1346239373 PECOS PAC ID: 2365433224 Enrollment ID: O20110526000807 |
| Provider Name | Mchs Hospitals Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1093221434 PECOS PAC ID: 5698071173 Enrollment ID: O20180208000096 |
| Provider Name | Lakeview Medical Center Inc Of Rice Lake |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1093201832 PECOS PAC ID: 6103737820 Enrollment ID: O20180817001484 |
| Provider Name | Mchs Hospitals Inc |
|---|---|
| Provider Type | Part A Provider - Critical Access Hospital |
| Provider Identifiers | NPI Number: 1952890873 PECOS PAC ID: 5698071173 Enrollment ID: O20180904002962 |
| Provider Name | Flambeau Hospital, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1194317966 PECOS PAC ID: 9032029871 Enrollment ID: O20210409000059 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Probasco, DPT 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Mark Probasco, DPT 130 Marvin Rd Se Ste 203, Lacey, WA 98503-6101 Ph: (360) 456-3300 |
Dorothy Kilvington, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 130 Marvin Rd Se Ste 203, Lacey, WA 98503 Phone: 360-456-3300 | |
Abigail Namocatcat, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4200 6th Ave Se, Suite 201, Lacey, WA 98503 Phone: 360-459-8311 | |
Nicole Dominique Jalandoni Vasquez, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1445 Galaxy Dr Ne Ste 301, Lacey, WA 98516 Phone: 360-456-1444 | |
Juman Park, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4800 College St Se, Lacey, WA 98503 Phone: 360-486-2900 | |
Samantha Rossi Perdue, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7940 29th Ave Ne Ste 101, Lacey, WA 98516 Phone: 360-870-2473 | |
Kathleen G Jech, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4770 Yelm Hwy Se, Lacey, WA 98503 Phone: 360-491-6074 Fax: 360-491-6192 | |
Michaela Jane De Groot, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4800 College St Se, Lacey, WA 98503 Phone: 360-486-2900 |