Marilou Ongat Agdaca, P.T.

Individual provider Active NPI Physical Therapist · Oneida, TN

NPI 1154540581 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154540581
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
3193 (TN)
Practice address
605 North Main Street
Oneida, TN 37841
Phone
(423) 569-1600
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3193TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Therapeutics, Inc. Past
since Aug 29, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3193 TN Yes

Addresses

Primary practice location

605 North Main Street
Oneida, TN 37841

Mailing address

150 Marlin Keeton Drive
Oneida, TN 37841
Phone (423) 569-1160

Other providers in Oneida, TN

All providers in Oneida, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.