Trent Harvick, | |
1200 N Pecan, Altus, OK 73521-6141 | |
(580) 379-5820 | |
Not Available |
Full Name | Trent Harvick |
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Gender | Male |
Speciality | Physical Therapist |
Location | 1200 N Pecan, Altus, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881045318 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 5144 (Oklahoma) | Primary |
Provider Name | Boomer 06 Pllc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1871126383 PECOS PAC ID: 3870924723 Enrollment ID: O20200511000968 |
Mailing Address | Practice Location Address |
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Trent Harvick, 3221 Northridge Cir, Altus, OK 73521-2356 Ph: () - | Trent Harvick, 1200 N Pecan, Altus, OK 73521-6141 Ph: (580) 379-5820 |
Cynthea Mika My Hosoda Lam, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 Fax: 580-379-5829 | |
Jamie Koeritz, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 | |
Mrs. Susan Elizabeth Spirlock, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 580-379-5820 | |
Mr. James Alonzo Patterson, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 301 E Broadway St, Altus, OK 73521 Phone: 580-477-3305 Fax: 580-477-2423 | |
Ms. Kirstie Lea Shive, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 E Broadway St, Altus, OK 73521 Phone: 580-477-3305 Fax: 580-477-2423 | |
Ken Simmons, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1100 Ranch Rd N, Altus, OK 73521 Phone: 580-471-1519 | |
Allison Howard, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1200 E Pecan St, Altus, OK 73521 Phone: 803-795-8205 Fax: 580-379-5829 |