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Showing codes 1417923533 — 1982671277
1417923533 -
LAURA
G
HOYT
MD
Other Name
:
Mailing Address
:
2910 CENTRE POINTE DR
CHILDRENS HEALTH CARE 35-121A
ROSEVILLE
MN
55113
Phone
: 651-855-2327;
Fax
: 651-855-2310;
Practice Location Address
:
347 NORTH SMITH AVE
, CHILDRENS SPECIALTY CLINIC INFECTIOUS DISEASES STPL
, ST PAUL
, MN
, 55102
Practice Phone
: 651-220-6444;
Practice Fax
: 651-220-7233
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1326014663 -
YUPING
WU
PA
Other Name
:
Mailing Address
:
PO BOX 64075
BALTIMORE
MD
21264-4075
Phone
: ;
Fax
: ;
Practice Location Address
:
19 FONTANA LN STE 206
,
, BALTIMORE
, MD
, 21237-3078
Practice Phone
: 410-391-6904;
Practice Fax
: 410-686-6640
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1134195472 -
MR.
MR.
JAMES
FRANK
VAN FLEET
FNP
Other Name
:
Mailing Address
:
650 JOEL DRIVE
FT CAMPBELL
KY
42223-5349
Phone
: 270-798-8372;
Fax
: 270-956-0180;
Practice Location Address
:
650 JOEL DRIVE
,
, FT CAMPBELL
, KY
, 42223-5349
Practice Phone
: 270-798-8372;
Practice Fax
: 270-956-0180
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1942276266 -
VICKI
M
NEWMAN
NP
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
40 HOLLAND ST
,
, SOMERVILLE
, MA
, 02144-2705
Practice Phone
: 617-629-6000;
Practice Fax
: 617-629-6070
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1568438794 -
DR.
DR.
ANGELA
M.
DEANTONIO
M.D.
Other Name
:
Mailing Address
:
100 N ACADEMY AVE
DANVILLE
PA
17822-3034
Phone
: 570-271-6144;
Fax
: 570-271-6578;
Practice Location Address
:
1000 E MOUNTAIN BLVD
,
, WILKES BARRE
, PA
, 18711-0027
Practice Phone
: 570-820-6114;
Practice Fax
: 570-826-7698
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1811963895 -
DR.
DR.
LISA
MARIE
TOEPP
M.D.
Other Name
:
Mailing Address
:
1650 COCHRANE CIR
USA MEDDAC, EVANS ARMY COMMUN
FORT CARSON
CO
80913-4603
Phone
: 719-526-7844;
Fax
: 719-526-7984;
Practice Location Address
:
1650 COCHRANE CIR
, USA MEDDAC, EVANS ARMY COMMUN
, FORT CARSON
, CO
, 80913-4603
Practice Phone
: 719-526-7844;
Practice Fax
: 719-526-7984
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1922074970 -
DR.
DR.
J.
CHARLENE
PERRYMAN
PSYD
Other Name
:
Mailing Address
:
MADIGAN ARMY MEDICAL CENTER ATTN:MCHJ-DA
TACOMA
WA
98431-0001
Phone
: 253-967-1442;
Fax
: 253-967-1411;
Practice Location Address
:
2006 A LIGGIT AVE.
,
, FT. LEWIS
, WA
, 98433
Practice Phone
: 253-967-1442;
Practice Fax
: 253-967-1411
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1932175130 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1679549810 -
CAROL
K
RACHEOTES
Other Name
:
Mailing Address
:
5221 N PARK RD
TEXARKANA
TX
75503-2664
Phone
: 903-791-1051;
Fax
: 903-791-1054;
Practice Location Address
:
5221 N PARK RD
,
, TEXARKANA
, TX
, 75503-2664
Practice Phone
: 903-791-1051;
Practice Fax
: 903-791-1054
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1063488138 -
SAMEER
K
MATHUR
MD PHD
Other Name
:
Mailing Address
:
7974 UW HEALTH CT
MIDDLETON
WI
53562-5531
Phone
: ;
Fax
: ;
Practice Location Address
:
600 HIGHLAND AVE
,
, MADISON
, WI
, 53792
Practice Phone
: 608-263-6180;
Practice Fax
: 608-263-9103
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1669448502 -
MR.
MR.
JAMES
LEE
GIRDLEY
MA, LMHC
Other Name
:
Mailing Address
:
325 NATIONAL RD W
RICHMOND
IN
47374-4152
Phone
: 765-966-3113;
Fax
: ;
Practice Location Address
:
325 NATIONAL RD W
,
, RICHMOND
, IN
, 47374-4152
Practice Phone
: 765-966-3113;
Practice Fax
:
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1164498036 -
MRS.
MRS.
CHRISTINE
O
WORK
LPC, LMFT
Other Name
:
Mailing Address
:
249 W YORK ST
NORFOLK
VA
23510-1520
Phone
: 757-622-6794;
Fax
: 757-626-1509;
Practice Location Address
:
249 W YORK ST
,
, NORFOLK
, VA
, 23510-1520
Practice Phone
: 757-622-6794;
Practice Fax
: 757-626-1509
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1548236433 -
DONNA
J
ADAMS
MSW, LCSW
Other Name
:
Mailing Address
:
831 DILLON DR
PO BOX 487
RICHMOND
IN
47374-8048
Phone
: 765-983-8000;
Fax
: ;
Practice Location Address
:
390 ERIE AVE
,
, CONNERSVILLE
, IN
, 47331-3177
Practice Phone
: 765-825-4124;
Practice Fax
:
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1477520351 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1386611200 -
THOMAS
R.
NOETHLICH
DO
Other Name
:
Mailing Address
:
PO BOX 30031
PENSACOLA
FL
32503-1031
Phone
: 850-478-1312;
Fax
: 850-474-9060;
Practice Location Address
:
1000 W MORENO ST
,
, PENSACOLA
, FL
, 32501-2316
Practice Phone
: 850-478-1312;
Practice Fax
: 850-474-9060
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1558338376 -
MR.
MR.
FRANK
GLOVER
WITHERSPOON
JR.
MD
Other Name
:
Mailing Address
:
1455 UNION AVE
MEMPHIS
TN
38104-6727
Phone
: 901-726-6655;
Fax
: 901-726-9056;
Practice Location Address
:
1455 UNION AVE
,
, MEMPHIS
, TN
, 38104-6727
Practice Phone
: 901-726-6655;
Practice Fax
: 901-726-9056
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1215903349 -
MS.
MS.
BRONWYN
E.
BROOKS
R.P.T.
Other Name
:
Mailing Address
:
901 ENGLEWOOD PKWY
# 108
ENGLEWOOD
CO
80110-2305
Phone
: 303-761-3085;
Fax
: 303-761-4066;
Practice Location Address
:
901 ENGLEWOOD PKWY
, # 108
, ENGLEWOOD
, CO
, 80110-2305
Practice Phone
: 303-761-3085;
Practice Fax
: 303-761-4066
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1518934470 -
MR.
MR.
CHRISTOPHER
A
ROBINSON
C.O, A.T.C
Other Name
:
Mailing Address
:
24W577 SPRINGDALE DR
NAPERVILLE
IL
60540-3743
Phone
: 630-548-2260;
Fax
: ;
Practice Location Address
:
625 ENTERPRISE DR
,
, OAK BROOK
, IL
, 60523-8813
Practice Phone
: 630-575-6200;
Practice Fax
:
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1275500092 -
DR.
DR.
CARIN
LAMM
M.D.
Other Name
:
Mailing Address
:
21 E 87TH ST
APARTMENT 5B
NEW YORK
NY
10128-0506
Phone
: 917-626-1993;
Fax
: ;
Practice Location Address
:
3959 BROADWAY
, BHS 701
, NEW YORK
, NY
, 10032-1559
Practice Phone
: 212-305-2406;
Practice Fax
:
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1700853520 -
MRS.
MRS.
ROBIN
H
FRIEDMAN-MUSICANTE
MD
Other Name
:
Mailing Address
:
1455 UNION AVENUE
MEMPHIS
TN
38104-6727
Phone
: 901-726-6655;
Fax
: 901-726-9056;
Practice Location Address
:
1455 UNION AVENUE
,
, MEMPHIS
, TN
, 38104-6727
Practice Phone
: 901-726-6655;
Practice Fax
: 901-726-9056
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1235106055 -
MR.
MR.
LEE
ALLEN
MD
Other Name
:
Mailing Address
:
1455 UNION AVENUE
MEMPHIS
TN
38104-6727
Phone
: 901-726-6655;
Fax
: 901-726-9056;
Practice Location Address
:
1455 UNION AVENUE
,
, MEMPHIS
, TN
, 38104-6727
Practice Phone
: 901-726-6655;
Practice Fax
: 901-726-9056
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1871560599 -
DANIEL
LEON
TURLEY
MD
Other Name
:
Mailing Address
:
PO BOX 6907
DOTHAN
AL
36302
Phone
: 334-793-5000;
Fax
: 334-615-8419;
Practice Location Address
:
4370 W MAIN STREET
,
, DOTHAN
, AL
, 36305
Practice Phone
: 334-793-5000;
Practice Fax
: 334-615-8419
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1972579027 -
DR.
DR.
ROBERT
LEWIS
KEITH
PH.D.
Other Name
:
Mailing Address
:
86 LAKE ST
BURLINGTON
VT
05401-5297
Phone
: 802-865-3450;
Fax
: 802-860-5011;
Practice Location Address
:
86 LAKE ST
,
, BURLINGTON
, VT
, 05401-5297
Practice Phone
: 802-865-3450;
Practice Fax
: 802-860-5011
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1245206291 -
DEBRA
S
LALLEY
CNS
Other Name
:
Mailing Address
:
1406 6TH AVE N
ST CLOUD HOSPITAL BEHAVIORAL HEALTH CLINIC
ST CLOUD
MN
56303
Phone
: 320-229-4908;
Fax
: 320-656-7026;
Practice Location Address
:
1406 6TH AVE N
, ST CLOUD HOSPITAL BEHAVIORAL HEALTH CLINIC
, ST CLOUD
, MN
, 56303
Practice Phone
: 320-229-4908;
Practice Fax
: 320-656-7026
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1699741652 -
MICHAEL
K
RICHARDS
MD
Other Name
:
Mailing Address
:
2910 CENTRE POINTE DRIVE
35 121A CHILDRENS HEALTH CARE
ROSEVILLE
MN
55113
Phone
: 651-855-2109;
Fax
: 651-855-2310;
Practice Location Address
:
2525 CHICAGO AVENUE SOUTH
, CHILDRENS SPECIALTY CLINIC HEMATOLOGY ONCOLOGY MPLS
, MINNEAPOLIS
, MN
, 55404
Practice Phone
: 612-813-5940;
Practice Fax
: 612-813-6325
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1144296104 -
DR.
DR.
THOMAS
M.
STALLONE
PSY.D.
Other Name
:
Mailing Address
:
100 EAST 13TH STREET,
SUITE 105
VANCOUVER
WA
98660-3327
Phone
: 360-696-1646;
Fax
: 360-571-8460;
Practice Location Address
:
100 E 13TH ST
, SUITE 105
, VANCOUVER
, WA
, 98660-3326
Practice Phone
: 360-696-1646;
Practice Fax
: 360-571-8460
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1174591101 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1518935576 -
MR.
MR.
ERNEST
LAWSON
JR.
MA
Other Name
:
Mailing Address
:
508 PROVIDENCE HALL DR
SANFORD
NC
27330-7402
Phone
: 336-939-3673;
Fax
: ;
Practice Location Address
:
5-4257 BASTOGNE & REILY STREET
,
, FORT BRAGG
, NC
, 28310-0001
Practice Phone
: 910-907-9653;
Practice Fax
: 910-907-8847
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1457329369 -
MS.
MS.
YVONNE
A.
WILLIAMS
M.S.W.
Other Name
:
Mailing Address
:
411 OAK ST
STERLING MEDICAL ASSOCIATES, ATTN. CREDENTIALING
CINCINNATI
OH
45219-2598
Phone
: 513-984-1800;
Fax
: 513-984-4909;
Practice Location Address
:
411 OAK ST
, STERLING MEDICAL ASSOCIATES, ATTN. CREDENTIALING
, CINCINNATI
, OH
, 45219-2598
Practice Phone
: 513-984-1800;
Practice Fax
: 513-984-4909
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1982672895 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1902874738 -
DR.
DR.
BENEDETTO
BENNY
VITULLO
M.D.
Other Name
:
Mailing Address
:
1800 ENGLISH ROAD
SUITE 10
ROCHESTER
NY
14616-1600
Phone
: 585-225-2525;
Fax
: 585-225-2626;
Practice Location Address
:
1800 ENGLISH ROAD
, SUITE 10
, ROCHESTER
, NY
, 14616-1600
Practice Phone
: 585-225-2525;
Practice Fax
: 585-225-2626
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1538137351 -
SAKDIDEJ
SUWAN
M.D.
Other Name
:
Mailing Address
:
419 MARKET ST
FREEPORT
PA
16229-1121
Phone
: 724-295-5202;
Fax
: 724-295-1160;
Practice Location Address
:
419 MARKET ST
,
, FREEPORT
, PA
, 16229-1121
Practice Phone
: 724-295-5202;
Practice Fax
: 724-295-1160
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1982672754 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1366410144 -
SANDRA
L
UNTIED
RN, BSN, MSW, LISW
Other Name
:
Mailing Address
:
6481 WELSH RD
NASHPORT
OH
43830-9512
Phone
: 740-454-9841;
Fax
: ;
Practice Location Address
:
2845 BELL ST
,
, ZANESVILLE
, OH
, 43701-1720
Practice Phone
: 740-454-9766;
Practice Fax
: 740-588-6452
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1598733594 -
JOAN
L
TOOMEY
NP
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
230 WORCESTER ST
,
, WELLESLEY
, MA
, 02481-5420
Practice Phone
: 781-431-5200;
Practice Fax
: 781-431-5298
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1174591002 -
JAMES
W
MOLD
MD
Other Name
:
Mailing Address
:
1122 NE 13TH ST
ORI236
OKLAHOMA CITY
OK
73117-1039
Phone
: 405-271-1515;
Fax
: ;
Practice Location Address
:
900 NE 10TH ST
,
, OKLAHOMA CITY
, OK
, 73104-5420
Practice Phone
: 405-271-4311;
Practice Fax
:
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1386612232 -
MRS.
MRS.
CHRISTINA
HANES
PRUESS
LPC, NCC
Other Name
:
Mailing Address
:
132 POPLAR GROVE CONNECTOR
SUITE B
BOONE
NC
28607-5915
Phone
: 828-264-8759;
Fax
: 828-262-5687;
Practice Location Address
:
132 POPLAR GROVE CONNECTOR
, SUITE B
, BOONE
, NC
, 28607-5915
Practice Phone
: 828-264-8759;
Practice Fax
: 828-262-5687
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1821066770 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1558339408 -
RAYMOND
HAWLEY
MD
Other Name
:
Mailing Address
:
PO BOX 293
COFFEYVILLE
KS
67337-0293
Phone
: 316-685-8428;
Fax
: 316-652-0340;
Practice Location Address
:
1400 W 4TH ST
,
, COFFEYVILLE
, KS
, 67337-3306
Practice Phone
: 620-252-1547;
Practice Fax
: 316-652-0340
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1992773857 -
DR.
DR.
ROBERT
HORTON
DDS
Other Name
:
Mailing Address
:
2830 VICTORY PKWY
STE. 320
CINCINNATI
OH
45206-1785
Phone
: 513-245-3300;
Fax
: 513-245-3303;
Practice Location Address
:
222 PIEDMONT AVE
, STE. 7300
, CINCINNATI
, OH
, 45219-4231
Practice Phone
: 513-475-8783;
Practice Fax
: 513-475-7698
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1477521227 -
DAVID
BRIAN
LOVICE
MD
Other Name
:
Mailing Address
:
100 N SUMTER ST
SUITE 400
SUMTER
SC
29150-4916
Phone
: 803-778-5970;
Fax
: 803-778-5403;
Practice Location Address
:
100 N SUMTER ST
, SUITE 400
, SUMTER
, SC
, 29150-4916
Practice Phone
: 803-778-5970;
Practice Fax
: 803-778-5403
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1124096987 -
DOUGLAS
FRIESEN
MD
Other Name
:
Mailing Address
:
PO BOX 1148
WICHITA
KS
67201-1148
Phone
: 316-685-3698;
Fax
: 316-652-0340;
Practice Location Address
:
10014 W GREENSPOINT ST
,
, WICHITA
, KS
, 67205-1581
Practice Phone
: 316-946-5980;
Practice Fax
: 316-652-0340
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1861460594 -
PHYLLIS
E.
LEAVITT
M.A.
Other Name
:
Mailing Address
:
208 LAS MANANITAS ST
SANTA FE
NM
87501-1546
Phone
: 505-986-0756;
Fax
: 505-983-4638;
Practice Location Address
:
208 LAS MANANITAS ST
,
, SANTA FE
, NM
, 87501-1546
Practice Phone
: 505-986-0756;
Practice Fax
: 505-983-4638
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1538137146 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1174591978 -
KEITH
M
BOYD
M.D.
Other Name
:
Mailing Address
:
1645 W JACKSON BLVD
SUITE 215
CHICAGO
IL
60612-3276
Phone
: 312-942-8000;
Fax
: ;
Practice Location Address
:
1645 W JACKSON BLVD
, SUITE 215
, CHICAGO
, IL
, 60612-3276
Practice Phone
: 312-942-8000;
Practice Fax
:
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1265400964 -
ROBERT
D
PATTERSON
MD
Other Name
:
Mailing Address
:
21 BLOSSOM ST
LEXINGTON
MA
02421-8103
Phone
: 617-510-1318;
Fax
: ;
Practice Location Address
:
21 BLOSSOM ST
,
, LEXINGTON
, MA
, 02421-8103
Practice Phone
: 617-510-1318;
Practice Fax
:
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1376511907 -
DR.
DR.
JAMES
E
BURNS
M.D.
Other Name
:
Mailing Address
:
5666 ADVANCE MILLS RD
RUCKERSVILLE
VA
22968-1500
Phone
: 434-973-2537;
Fax
: ;
Practice Location Address
:
109 GOVERNOR ST
, ROOM 1314
, RICHMOND
, VA
, 23219-3623
Practice Phone
: 804-864-7002;
Practice Fax
: 804-864-7023
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1063480606 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
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:
,
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,
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: ;
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:
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1790752319 -
MR.
MR.
SAMUEL
PATRICK
FOGLE
M.S., L.P.C.
Other Name
:
Mailing Address
:
1219 E SOUTH 11TH ST
SUITE A
ABILENE
TX
79602-4283
Phone
: 325-676-2039;
Fax
: 325-480-4784;
Practice Location Address
:
1219 E SOUTH 11TH ST
, SUITE A
, ABILENE
, TX
, 79602-4283
Practice Phone
: 325-676-2039;
Practice Fax
: 325-480-4784
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1346217999 -
MICHAEL
NITARI
DARVILLE
MD
Other Name
:
Mailing Address
:
304 CAMILLE COURT
ANTIOCH
TN
37013
Phone
: 615-429-2903;
Fax
: 615-837-4514;
Practice Location Address
:
1412 COUNTY HOSPITAL RD
,
, NASHVILLE
, TN
, 37218
Practice Phone
: 615-364-4158;
Practice Fax
: 615-837-4514
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1447227996 -
KATHLEEN
MARIE
ROEDER
M.S., A.R.N.P., B.C.
Other Name
:
Mailing Address
:
10248 ARROW CREEK RD
NEW PORT RICHEY
FL
34655-4305
Phone
: 727-375-9361;
Fax
: ;
Practice Location Address
:
9912 LITTLE RD
, VA OUTPATIENT CLINIC PASCO
, NEW PORT RICHEY
, FL
, 34654-3419
Practice Phone
: 727-869-4153;
Practice Fax
: 727-869-4193
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1154398600 -
MR.
MR.
JAMES
EDWARD
BUCCIARELLI
Other Name
:
Mailing Address
:
3 MERRITT DR
HUDSON
MA
01749-1775
Phone
: 978-562-5070;
Fax
: ;
Practice Location Address
:
135 N BEACON ST
,
, WATERTOWN
, MA
, 02472-2751
Practice Phone
: 617-926-8720;
Practice Fax
: 617-926-8920
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1427026129 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
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:
,
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,
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: ;
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:
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1306814009 -
STEVEN
W
PELTIER
PH.D., L.P., L.M.F.T
Other Name
:
Mailing Address
:
761 LINCOLN AVE
SAINT PAUL
MN
55105-3348
Phone
: ;
Fax
: ;
Practice Location Address
:
311 RAMSEY ST
, RAMSEY PROFESSIONAL BLDG.
, SAINT PAUL
, MN
, 55102-2323
Practice Phone
: 651-293-0811;
Practice Fax
:
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1770551491 -
MR.
MR.
DOUGLAS
C
NEWCOMB
LCSW-R, CASAC, MPA
Other Name
:
Mailing Address
:
16 N GOODMAN ST
SUITE 227
ROCHESTER
NY
14607-1554
Phone
: 585-461-0844;
Fax
: 585-461-0844;
Practice Location Address
:
16 N GOODMAN ST
, SUITE 227
, ROCHESTER
, NY
, 14607-1554
Practice Phone
: 585-461-0844;
Practice Fax
: 585-461-0844
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1427026145 -
ANTONIO
DURAZO
JR.
M.D.
Other Name
:
Mailing Address
:
17452 ROAD 232
PORTERVILLE
CA
93257-9555
Phone
: 559-781-8080;
Fax
: 559-781-8960;
Practice Location Address
:
841 W MORTON AVE
,
, PORTERVILLE
, CA
, 93257-3184
Practice Phone
: 559-781-8080;
Practice Fax
: 559-781-8960
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1912975699 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
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:
,
,
,
,
Practice Phone
: ;
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:
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1861460412 -
DR.
DR.
MARTHA
S.
GHOSH
M.D.
Other Name
:
Mailing Address
:
100 N ACADEMY AVE
DANVILLE
PA
17822-9800
Phone
: 570-271-6144;
Fax
: 570-271-6578;
Practice Location Address
:
1000 E MOUNTAIN BLVD
,
, WILKES BARRE
, PA
, 18711-0027
Practice Phone
: 570-819-5780;
Practice Fax
: 570-826-7937
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1497723043 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
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:
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1194793752 -
DR.
DR.
ROBERT
C
PASCUCCI
MD
Other Name
:
Mailing Address
:
9 LIVINGSTON RD
WELLESLEY
MA
02482-7307
Phone
: 781-237-0868;
Fax
: ;
Practice Location Address
:
300 LONGWOOD AVE
,
, BOSTON
, MA
, 02115-5724
Practice Phone
: 617-355-7327;
Practice Fax
:
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1376511931 -
EDWARD
STEPHEN
ELLIS
M.D
Other Name
:
Mailing Address
:
7317 PARLIAMENT DR
KNOXVILLE
TN
37919-7212
Phone
: 865-690-2759;
Fax
: ;
Practice Location Address
:
110 DEER XING
,
, VONORE
, TN
, 37885-2133
Practice Phone
: 423-884-6958;
Practice Fax
: 423-884-6959
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1043287444 -
DR.
DR.
SUSAN
BARBARA
ARNOLD
PHARM.D.
Other Name
:
Mailing Address
:
4986 LOCKARD DR
OWINGS MILLS
MD
21117-6116
Phone
: 410-363-4841;
Fax
: 410-955-1545;
Practice Location Address
:
6000 N. CAROLINE STREET
,
, BALTIMORE
, MD
, 21287-0001
Practice Phone
: 410-955-6357;
Practice Fax
: 410-955-1545
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1881662559 -
LAURA
AMATEA
EDS,LMFT,LMHC,NCC
Other Name
:
Mailing Address
:
3410 SE 2ND ST
OCALA
FL
34471-2950
Phone
: 352-629-4525;
Fax
: 352-629-4525;
Practice Location Address
:
1294 SE 24TH RD
,
, OCALA
, FL
, 34471-6010
Practice Phone
: 352-629-4525;
Practice Fax
: 352-629-4525
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1285601773 -
DR.
DR.
STEVEN
B.
EISNER
M.D.
Other Name
:
Mailing Address
:
100 N ACADEMY AVE
DANVILLE
PA
17822-3034
Phone
: 570-271-6144;
Fax
: 570-271-6578;
Practice Location Address
:
2300 ADAMS AVE
,
, SCRANTON
, PA
, 18509-1514
Practice Phone
: 570-558-6160;
Practice Fax
:
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1255308748 -
DEBRA
DREWEK
ROTHSCHILD
NP
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
230 WORCESTER ST
,
, WELLESLEY
, MA
, 02481-5420
Practice Phone
: 781-431-5200;
Practice Fax
: 781-431-5298
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1952378309 -
RAJENDRA
SHRIVASTAV
MD
Other Name
:
Mailing Address
:
1512 W REYNOLDS ST
STE. B
PONTIAC
IL
61764-9781
Phone
: 815-842-3023;
Fax
: 815-842-3241;
Practice Location Address
:
1512 W REYNOLDS ST
, STE. B
, PONTIAC
, IL
, 61764-9781
Practice Phone
: 815-842-3023;
Practice Fax
: 815-842-3241
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1124095419 -
MS.
MS.
SUSAN
RUTH
LIFER
PT
Other Name
:
Mailing Address
:
100 TAYLOR ST
LINCOLN
ME
04457-1167
Phone
: 207-794-8025;
Fax
: ;
Practice Location Address
:
100 TAYLOR ST
,
, LINCOLN
, ME
, 04457-1167
Practice Phone
: 207-794-8025;
Practice Fax
:
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1154398469 -
AMY
LYNN
ANKROM
CRNP MSN
Other Name
:
Mailing Address
:
180 FORT COUCH RD
STE 304
PITTSBURGH
PA
15241-1041
Phone
: 412-831-0355;
Fax
: 412-854-5152;
Practice Location Address
:
180 FORT COUCH RD
, STE 304
, PITTSBURGH
, PA
, 15241-1041
Practice Phone
: 412-831-0355;
Practice Fax
: 412-854-5152
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1669449989 -
MRS.
MRS.
JENNIFER
SAUNDERS
SHEPHERD
PT/ATC
Other Name
:
Mailing Address
:
110 DEER XING
VONORE
TN
37885-2133
Phone
: 423-884-1901;
Fax
: 423-884-2686;
Practice Location Address
:
110 DEER XING
,
, VONORE
, TN
, 37885-2133
Practice Phone
: 423-884-1901;
Practice Fax
: 423-884-2686
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1558339531 -
MS.
MS.
MARGARET
FIORE
NP
Other Name
:
Mailing Address
:
2150 PENNSYLVANIA AVE NW
7TH FLOOR
WASHINGTON
DC
20037-3201
Phone
: 202-741-2750;
Fax
: ;
Practice Location Address
:
2150 PENNSYLVANIA AVE NW
, 7TH FLOOR
, WASHINGTON
, DC
, 20037-3201
Practice Phone
: 202-741-2750;
Practice Fax
:
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1447228382 -
DR.
DR.
MARY
SUSAN
OLIVER
MD
Other Name
:
Mailing Address
:
PO BOX 235019
MONTGOMERY
AL
36123-5019
Phone
: 334-279-1450;
Fax
: 334-279-1660;
Practice Location Address
:
400 CHARTER BLVD
,
, MACON
, GA
, 31210-4831
Practice Phone
: 478-745-8871;
Practice Fax
:
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1518935451 -
DR.
DR.
GEETANJALI
SRIVASTAVA
MD
Other Name
:
Mailing Address
:
304 E DUNCAN AVE
APT #G
ALEXANDRIA
VA
22301-1290
Phone
: 917-519-8782;
Fax
: ;
Practice Location Address
:
111 MICHIGAN AVE NW
, CHILDREN'S NATIONAL MEDICAL CENTER
, WASHINGTON
, DC
, 20010-2978
Practice Phone
: 202-884-4177;
Practice Fax
:
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1093782567 -
LINDA
S
SOUTHWICK
PA
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
2 ESSEX CENTER DR
,
, PEABODY
, MA
, 01960-2902
Practice Phone
: 978-977-4000;
Practice Fax
:
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1447227723 -
MS.
MS.
LINKA
SUZANNE
MALMIN
Other Name
:
Mailing Address
:
15601 WOOD LN
TYLER
TX
75707-6943
Phone
: 903-565-4025;
Fax
: ;
Practice Location Address
:
15601 WOOD LN
,
, TYLER
, TX
, 75707-6943
Practice Phone
: 903-565-4025;
Practice Fax
:
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1760459069 -
MR.
MR.
JOHN
D
HUBER
III
MD
Other Name
:
Mailing Address
:
1455 UNION AVENUE
MEMPHIS
TN
38104-6727
Phone
: 901-726-6655;
Fax
: 901-726-9056;
Practice Location Address
:
1455 UNION AVENUE
,
, MEMPHIS
, TN
, 38104-6727
Practice Phone
: 901-726-6655;
Practice Fax
: 901-726-9056
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1104893411 -
DR.
DR.
ANNA
R
FLYNN
MD
Other Name
:
Mailing Address
:
1701 E WOODFIELD RD
SUITE 1000
SCHAUMBURG
IL
60173-5905
Phone
: 847-240-2211;
Fax
: 847-240-2418;
Practice Location Address
:
1701 E WOODFIELD RD
, SUITE 1000
, SCHAUMBURG
, IL
, 60173-5905
Practice Phone
: 847-240-2211;
Practice Fax
: 847-240-2418
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1992772206 -
DR.
DR.
JOHN
DALE
ALDEN
III
PH.D.
Other Name
:
Mailing Address
:
1324 TROTWOOD AVE
10
COLUMBIA
TN
38401-4750
Phone
: 615-351-3987;
Fax
: 931-380-0058;
Practice Location Address
:
1324 TROTWOOD AVE
, 10
, COLUMBIA
, TN
, 38401-4750
Practice Phone
: 615-351-3987;
Practice Fax
: 931-380-0058
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1518934868 -
DR.
DR.
MARY
ELIZABETH
GABRIEL
MD
Other Name
:
MARY
ELIZABETH
MOHER
Mailing Address
:
2817 REILLY ROAD MCXCCOD CREDENTIALS
WOMACK ARMY MEDICAL CENTER
FORT BRAGG
NC
28310
Phone
: 910-907-8922;
Fax
: 910-907-6069;
Practice Location Address
:
2817 REILLY RD
, WOMACK ARMY MEDICAL CENTER DOOH PES MEB
, FT BRAGG
, NC
, 28310
Practice Phone
: 910-907-9891;
Practice Fax
: 910-907-8451
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1932176286 -
CHARLES
A
HAISLET
MD
Other Name
:
Mailing Address
:
6545 FRANCE AVE S
SUITE 540
EDINA
MN
55435-2131
Phone
: 952-927-4045;
Fax
: 952-924-4133;
Practice Location Address
:
6545 FRANCE AVE S
, SUITE 540
, EDINA
, MN
, 55435-2131
Practice Phone
: 952-927-4045;
Practice Fax
: 952-924-4133
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1598732752 -
DAVID
E
FISHER
MD PHD
Other Name
:
Mailing Address
:
44 BINNEY STREET
DANA 630 DFCI
BOSTON
MA
02115-6084
Phone
: 617-632-4916;
Fax
: 617-632-2085;
Practice Location Address
:
44 BINNEY STREET
, DANA 630 DFCI
, BOSTON
, MA
, 02115-6084
Practice Phone
: 617-632-4916;
Practice Fax
: 617-632-2085
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1073580288 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
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:
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1861460719 -
MR.
MR.
PATRICK
ALFRED
CREBBIN
PT CHT
Other Name
:
Mailing Address
:
1929 VAN NESS AVE
KLAMATH FALLS
OR
97601
Phone
: 541-882-2191;
Fax
: ;
Practice Location Address
:
2301 MOUNTAIN VIEW BLVD
, SUITE C
, KLAMATH FALLS
, OR
, 97601
Practice Phone
: 541-883-3327;
Practice Fax
: 541-883-3175
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1841268794 -
JOHN
WESCOTT
CONBOY
MD
Other Name
:
Mailing Address
:
8390 CHAMPIONS GATE BLVD
SUITE 306
CHAMPIONS GATE
FL
33896
Phone
: 407-390-1677;
Fax
: 407-390-1765;
Practice Location Address
:
40100 HWY 27
,
, DAVENPORT
, FL
, 33837
Practice Phone
: 863-422-4971;
Practice Fax
:
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1285602045 -
EDWARD
WADE
MD
Other Name
:
Mailing Address
:
PO BOX 1148
WICHITA
KS
67201-1148
Phone
: 316-685-3698;
Fax
: 316-652-0340;
Practice Location Address
:
10014 W GREENSPOINT ST
,
, WICHITA
, KS
, 67205-1581
Practice Phone
: 316-946-5980;
Practice Fax
: 316-652-0340
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1073580544 -
MADELEINE
G
ST.DENIS
NP
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
133 BROOKLINE AVE
,
, BOSTON
, MA
, 02215-3904
Practice Phone
: 617-421-1000;
Practice Fax
: 617-421-6084
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1255308631 -
SAKINEH
ILIAIFAR
X
MD
Other Name
:
Mailing Address
:
24800 SE STARK ST
GRESHAM
OR
97030-3378
Phone
: ;
Fax
: ;
Practice Location Address
:
24900 SE STARK ST
, SUITE #110
, GRESHAM
, OR
, 97030-3355
Practice Phone
: 503-465-6850;
Practice Fax
:
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1598732133 -
PHILLIP
RAY
BACILLA
JR.
MD
Other Name
:
Mailing Address
:
3351 MASONIC DRIVE
ALEXANDRIA
LA
71301-3842
Phone
: 318-473-9556;
Fax
: 318-441-8339;
Practice Location Address
:
3351 MASONIC DRIVE
,
, ALEXANDRIA
, LA
, 71301-3842
Practice Phone
: 318-473-9556;
Practice Fax
: 318-441-8339
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1205803715 -
PATRICIA
MACIBORSKI
PT
Other Name
:
Mailing Address
:
71 GRIST MILL DR
BELLE MEAD
NJ
08502-5505
Phone
: 908-874-4883;
Fax
: ;
Practice Location Address
:
71 GRIST MILL DR
,
, BELLE MEAD
, NJ
, 08502-5505
Practice Phone
: 908-874-4883;
Practice Fax
:
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1821065343 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1053388587 -
GREGORY
W.
LITTLE
MD
Other Name
:
Mailing Address
:
150 INFIRMARY WAY
AMHERST
MA
01003-9288
Phone
: 413-577-5000;
Fax
: 413-577-5440;
Practice Location Address
:
150 INFIRMARY WAY
,
, AMHERST
, MA
, 01003-9288
Practice Phone
: 413-577-5000;
Practice Fax
: 413-577-5440
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1710954334 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1326015959 -
MRS.
MRS.
MEGAN
LEE
KENDALL
RD LD
Other Name
:
MEGAN
LEE
MAHAN
Mailing Address
:
306 LOUISIANA RD
DYERS AFB
TX
79607
Phone
: 325-518-6173;
Fax
: 325-690-5228;
Practice Location Address
:
765 ORANGE
,
, ABILENE
, TX
, 79603
Practice Phone
: 325-690-5131;
Practice Fax
: 325-690-5228
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1609843119 -
DR.
DR.
FRAYDOON
ESFAHANI
M.D.
Other Name
:
Mailing Address
:
100 N ACADEMY AVE
DANVILLE
PA
17822-3034
Phone
: 570-271-6144;
Fax
: 570-271-6578;
Practice Location Address
:
100 N ACADEMY AVE
,
, DANVILLE
, PA
, 17822-2007
Practice Phone
: 570-271-6301;
Practice Fax
:
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1710954276 -
OANA
D
MANTA
MD
Other Name
:
Mailing Address
:
PO BOX 2004
EAST SYRACUSE
NY
13057-4504
Phone
: 315-446-3904;
Fax
: 315-445-2936;
Practice Location Address
:
736 IRVING AVE
,
, SYRACUSE
, NY
, 13210-1687
Practice Phone
: 315-470-8837;
Practice Fax
: 315-470-2961
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1013984582 -
HENRY
W
STOLL
PA
Other Name
:
Mailing Address
:
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON
MA
02109-4806
Phone
: 617-559-8053;
Fax
: 617-421-3487;
Practice Location Address
:
40 HOLLAND ST
,
, SOMERVILLE
, MA
, 02144-2705
Practice Phone
: 617-629-6000;
Practice Fax
: 617-629-6070
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1699742130 -
LYNN
FRAASS
PT
Other Name
:
Mailing Address
:
6 MILL LN
DAYTON
NJ
08810-1601
Phone
: 732-329-1655;
Fax
: ;
Practice Location Address
:
6 MILL LN
,
, DAYTON
, NJ
, 08810-1601
Practice Phone
: 732-329-1655;
Practice Fax
:
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1871560268 -
DR.
DR.
LAURIE
POLIS
M.D.
Other Name
:
Mailing Address
:
62 CROSBY ST
NEW YORK
NY
10012-4410
Phone
: 212-431-1600;
Fax
: 212-431-7521;
Practice Location Address
:
62 CROSBY ST
,
, NEW YORK
, NY
, 10012-4410
Practice Phone
: 212-431-1600;
Practice Fax
: 212-431-7521
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1558338954 -
JOAN
S
FINE
M.D.
Other Name
:
Mailing Address
:
123 DWIGHT RD
SUITE 11
LONGMEADOW
MA
01106-1748
Phone
: 413-567-1031;
Fax
: 413-567-7683;
Practice Location Address
:
123 DWIGHT RD
, SUITE 11
, LONGMEADOW
, MA
, 01106-1748
Practice Phone
: 413-567-1031;
Practice Fax
: 413-567-7683
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1265409833 -
ERICA
ANNICE
ALESSANDRINI
CRNP
Other Name
:
ERICA
ANNICE
BRIGSON
Mailing Address
:
25375 CLUB CIRCLE
QUANTICO
MD
21856
Phone
: 410-860-2757;
Fax
: ;
Practice Location Address
:
1101 CAMDEN AVE SUITE 180
, STUDENT HEALTH SERVICES HOLLOWAY HALL
, SALISBURY
, MD
, 21801
Practice Phone
: 410-543-6262;
Practice Fax
: 410-548-7101
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1982671277 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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