Nicole Fellows, PT | |
491 Cattle Drive Cir Ste 3, Myrtle Beach, SC 29588-3732 | |
(309) 360-2480 | |
Not Available |
Full Name | Nicole Fellows |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 491 Cattle Drive Cir Ste 3, Myrtle Beach, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205389871 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 11957 (South Carolina) | Secondary |
225100000X | Physical Therapist | 11044 (Connecticut) | Primary |
Provider Name | Trainer Physical Therapy, Inc. |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1538768684 PECOS PAC ID: 2163830019 Enrollment ID: O20211104002387 |
Mailing Address | Practice Location Address |
---|---|
Nicole Fellows, PT 491 Cattle Drive Cir Ste 3, Myrtle Beach, SC 29588-3732 Ph: (309) 360-2480 | Nicole Fellows, PT 491 Cattle Drive Cir Ste 3, Myrtle Beach, SC 29588-3732 Ph: (309) 360-2480 |
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Gavin Stepansky, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4871 Socastee Blvd Unit E, Myrtle Beach, SC 29588 Phone: 843-293-5610 | |
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