| Moira M Barone, PT, ATC | |
|
4 Cougar Dr Ste A, Glen Carbon, IL 62034 | |
| (618) 288-6361 | |
| Not Available |
| Full Name | Moira M Barone |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 4 Cougar Dr Ste A, Glen Carbon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508874892 | NPI | - | NPPES |
| 40376200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1105248 (Kansas) | Secondary |
| 225100000X | Physical Therapist | 9939 (Wisconsin) | Secondary |
| 225100000X | Physical Therapist | 070014287 (Illinois) | Primary |
| Provider Name | Phoenix Physical Therapy |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1659525368 PECOS PAC ID: 5991861049 Enrollment ID: O20090225000708 |
| Mailing Address | Practice Location Address |
|---|---|
| Moira M Barone, PT, ATC 2 Terminal Dr Ste 4b, East Alton, IL 62024-2296 Ph: (618) 288-6361 | Moira M Barone, PT, ATC 4 Cougar Dr Ste A, Glen Carbon, IL 62034 Ph: (618) 288-6361 |
Divya Merchant, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4955 S State Route 159, Glen Carbon, IL 62034 Phone: 618-288-4677 | |
Jesse Moore, DPT, MBA Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3008 Huntsville Dr, Glen Carbon, IL 62034 Phone: 317-691-6262 | |
Michelle Vermaux, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4802 S State Route 159, Glen Carbon, IL 62034 Phone: 618-288-4388 | |
Fitness Designs Physical Therapy And Sports Rehab Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 16 Ginger Creek Pkwy, Glen Carbon, IL 62034 Phone: 618-656-1122 Fax: 618-656-1171 | |
Ashley Lack, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 20 Junction Dr W Ste 4, Glen Carbon, IL 62034 Phone: 618-288-8020 | |
Mrs. Kelli D Evans, MSRPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 16 Ginger Creek Pkwy, Glen Carbon, IL 62034 Phone: 618-656-1122 Fax: 618-656-1171 | |
Mrs. Deanne Louise Perry, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 16 Ginger Creek Pkwy, Glen Carbon, IL 62034 Phone: 618-656-1122 Fax: 618-656-1171 |