| Nicolette Fonseca, PT, DPT | |
|
913 11th St Se Ste 2, Bandon, OR 97411-9168 | |
| (541) 347-4314 | |
| (541) 347-8006 |
| Full Name | Nicolette Fonseca |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 913 11th St Se Ste 2, Bandon, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538749817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 11-06089 (Kansas) | Secondary |
| 225100000X | Physical Therapist | 11972 (Tennessee) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Nicolette Fonseca, PT, DPT 2976 Iroquois Dr, Thompsons Station, TN 37179-5022 Ph: () - | Nicolette Fonseca, PT, DPT 913 11th St Se Ste 2, Bandon, OR 97411-9168 Ph: (541) 347-4314 |
Mackenzie Weisman, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 913 11th St Se, Bandon, OR 97411 Phone: 541-347-4314 | |
Paul Edward Smith, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 913 11th St Se Ste 2, Bandon, OR 97411 Phone: 541-347-4314 | |
Mrs. Courtney V Hiebing, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 11th St Se Ste 1, Bandon, OR 97411 Phone: 541-347-4314 | |
Mr. Tristan Proett, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 11th St Se, Suite 1, Bandon, OR 97411 Phone: 541-347-4314 Fax: 541-347-8006 |