Mr Elee Marcel Fairhart, PT | |
148 Division Street, Morton, WA 98356 | |
(360) 496-5335 | |
(360) 496-5181 |
Full Name | Mr Elee Marcel Fairhart |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 148 Division Street, Morton, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326044629 | NPI | - | NPPES |
8334781 | Medicaid | WA | |
131920 | Other | WA | L & I |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 00002616 (Washington) | Primary |
Provider Name | Mountain Physical Therapy And Sports Rehabilitation Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1740382050 PECOS PAC ID: 1355391004 Enrollment ID: O20050131000225 |
Mailing Address | Practice Location Address |
---|---|
Mr Elee Marcel Fairhart, PT Po Box 9, Morton, WA 98356-0009 Ph: (360) 496-5335 | Mr Elee Marcel Fairhart, PT 148 Division Street, Morton, WA 98356 Ph: (360) 496-5335 |
Mrs. Darla Sue Carbaugh, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 250 C Westlake Avenue, Morton, WA 98356 Phone: 360-496-0087 Fax: 360-496-0078 | |
Chris Cott, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 521 Adams Ave, Morton, WA 98356 Phone: 360-496-5112 | |
Mrs. Margo Jeanette Cooper, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 148 Division St, Morton, WA 98356 Phone: 360-496-5335 Fax: 360-496-5181 | |
Pro Plus Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 250-c Westlake Avenue, Morton, WA 98356 Phone: 360-496-0087 | |
Family Physical Therapy And Sports Rehabilitation Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 148 Division Street, Morton, WA 98356 Phone: 360-496-5335 Fax: 360-496-5181 |