Tara Mckay Powers, | |
1022 E Wesley Dr, O Fallon, IL 62269-6136 | |
(618) 607-5081 | |
Not Available |
Full Name | Tara Mckay Powers |
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Gender | Female |
Speciality | Speech-language Pathologist |
Location | 1022 E Wesley Dr, O Fallon, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124476957 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 2016007624 (Missouri) | Secondary |
235Z00000X | Speech-language Pathologist | 146012948 (Illinois) | Primary |
Provider Name | Powerback Rehabilitation Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1982018362 PECOS PAC ID: 2365359932 Enrollment ID: O20141024000284 |
Mailing Address | Practice Location Address |
---|---|
Tara Mckay Powers, 967 Blackjack Rd, Troy, IL 62294-2723 Ph: (618) 670-2352 | Tara Mckay Powers, 1022 E Wesley Dr, O Fallon, IL 62269-6136 Ph: (618) 607-5081 |
Mrs. Lauren Michelle Heimbuecher, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 723 Insight Ave Ste 300, O Fallon, IL 62269 Phone: 618-607-0086 | |
Heidi E Wright, MS CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 634 N Main St Ste 3, O Fallon, IL 62269 Phone: 618-632-4222 | |
Amber Chappell., Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 634 N Main St, Suite 3, O Fallon, IL 62269 Phone: 618-632-4222 | |
Mrs. Jami Bossart, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 118 E Washington St, O Fallon, IL 62269 Phone: 618-632-3666 | |
Amy Jean Porter, MS, CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 505 S Cherry St, O Fallon, IL 62269 Phone: 618-632-3621 | |
Rosalie Maul, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 214 W 3rd St, O Fallon, IL 62269 Phone: 616-632-6327 | |
Taylor Marie Wiggins, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 723 Insight Ave Ste 300, O Fallon, IL 62269 Phone: 618-607-0086 Fax: 618-607-0042 |