Shelby Landrum, PT | |
1585 3rd St, Fort Johnson, LA 71459-5102 | |
(337) 531-3207 | |
Not Available |
Full Name | Shelby Landrum |
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Gender | Female |
Speciality | Physical Therapist |
Location | 1585 3rd St, Fort Johnson, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669184487 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 11421 (South Carolina) | Primary |
Provider Name | Grace Physical Therapy, Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1356544415 PECOS PAC ID: 1557452331 Enrollment ID: O20070808000449 |
Mailing Address | Practice Location Address |
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Shelby Landrum, PT 413 Durwin Way, Columbia, SC 29229-7212 Ph: (706) 818-5633 | Shelby Landrum, PT 1585 3rd St, Fort Johnson, LA 71459-5102 Ph: (337) 531-3207 |
Marco I Mirnics, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1585 3rd St, Fort Johnson, LA 71459 Phone: 615-609-1424 | |
Caleb O Johnson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1585 3rd St, Fort Johnson, LA 71459 Phone: 337-531-3119 | |
Gunner Coleman, DPT, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1585 3rd St, Fort Johnson, LA 71459 Phone: 337-531-3517 |