Rebecca Costello Shetlar, DPT | |
817 W Cherokee St, Wagoner, OK 74467-4616 | |
(812) 628-3060 | |
Not Available |
Full Name | Rebecca Costello Shetlar |
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Gender | Female |
Speciality | Physical Therapist |
Location | 817 W Cherokee St, Wagoner, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063105658 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Redbud Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1710437306 PECOS PAC ID: 4486939949 Enrollment ID: O20170323001896 |
Mailing Address | Practice Location Address |
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Rebecca Costello Shetlar, DPT 1650 Lyndon Farm Ct Ste 300, Louisville, KY 40223-5005 Ph: (812) 628-3060 | Rebecca Costello Shetlar, DPT 817 W Cherokee St, Wagoner, OK 74467-4616 Ph: (812) 628-3060 |
Jace Evan Sharp, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1200 W Cherokee St, Wagoner, OK 74467 Phone: 918-485-1212 Fax: 918-485-1335 | |
Jennifer Rae Murr, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 817 W Cherokee St, Wagoner, OK 74467 Phone: 918-485-3100 Fax: 918-485-3126 | |
Bradley Edward Holland, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 817 W Cherokee St, Wagoner, OK 74467 Phone: 918-485-3100 Fax: 918-485-3126 | |
Mr. Michael D Clark, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 W Cherokee St, Wagoner, OK 74467 Phone: 918-485-1323 Fax: 918-485-9486 |