Shelley Wiesel, OTR | |
4609 Grape Rd, Ste B-7, Mishawaka, IN 46545-2649 | |
(574) 360-8132 | |
(888) 370-2324 |
Full Name | Shelley Wiesel |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 4609 Grape Rd, Mishawaka, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316131113 | NPI | - | NPPES |
200876300 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 31003555A (Indiana) | Primary |
Provider Name | Powerback Rehabilitation Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1174275283 PECOS PAC ID: 2365359932 Enrollment ID: O20110708000322 |
Mailing Address | Practice Location Address |
---|---|
Shelley Wiesel, OTR 4609 Grape Rd, Suite B-7, Mishawaka, IN 46545-2649 Ph: (574) 360-8132 | Shelley Wiesel, OTR 4609 Grape Rd, Ste B-7, Mishawaka, IN 46545-2649 Ph: (574) 360-8132 |
Hunter Freeman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 60160 Bodnar Blvd, Mishawaka, IN 46544 Phone: 574-247-9441 Fax: 574-247-9442 | |
Ms. Christine Lybb Aragon, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4609 Grape Rd, Suite B7, Mishawaka, IN 46545 Phone: 269-268-5601 Fax: 888-370-2324 | |
Michael Wroblewski, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 620 W Edison Rd, Mishawaka, IN 46545 Phone: 574-931-2805 | |
Trevor David Manspeaker, OTD, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3630 Hickory Rd, Mishawaka, IN 46545 Phone: 574-252-7225 | |
Pamela K. Murphy, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 530 Tanglewood Ln, Mishawaka, IN 46545 Phone: 574-277-4310 | |
Kathleen Ann Zintsmaster, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1420 E Douglas Rd, Mishawaka, IN 46545 Phone: 574-307-7200 |