Mrs Lacey Ozburn, DPT | |
4616 Highway 84 W, Vidalia, LA 71373-3357 | |
(318) 336-5400 | |
(318) 336-8621 |
Full Name | Mrs Lacey Ozburn |
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Gender | Female |
Speciality | Physical Therapist |
Location | 4616 Highway 84 W, Vidalia, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043719040 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 09814 (Louisiana) | Primary |
Provider Name | Therapy Center For Physical Rehabilitation And Wellness Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1366782120 PECOS PAC ID: 3779887518 Enrollment ID: O20160405000327 |
Mailing Address | Practice Location Address |
---|---|
Mrs Lacey Ozburn, DPT 4616 Highway 84 W, Vidalia, LA 71373-3357 Ph: (318) 336-5400 | Mrs Lacey Ozburn, DPT 4616 Highway 84 W, Vidalia, LA 71373-3357 Ph: (318) 336-5400 |
Erin Fournet Woodruff, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 Holly Street, Vidalia, LA 71373 Phone: 318-336-6500 | |
Miss Jessica Marling Clayton, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4616 Highway 84 W, Vidalia, LA 71373 Phone: 318-336-5400 Fax: 318-336-8621 | |
Michael R Wimberly Ii, PT,MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 107 Front St, Suite 230, Vidalia, LA 71373 Phone: 318-336-2224 Fax: 318-336-6068 | |
James Justin Garner, PT,MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 107 Front Street, Suite 210, Vidalia, LA 71373 Phone: 318-336-2224 Fax: 318-336-6067 |