MEDICARE: PROCARE THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1821480344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROCARE THERAPY

Provider Business Mailing Address
First Line	:	303 PORTER DR
Second Line	:
City	:	INDIANOLA
State	:	MS
Zip	:	38751-3717
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 N EISENHOWER DR
Second Line	:
City	:	JUNCTION CITY
State	:	KS
Zip	:	66441-3313
Country	:	US
Telephone Number	:	785-717-9340
Fax Number	:

Authorized Official
Title or Position	:	SLPA
Name	:	KANOUSHA BURTON-MARTIN
Credential	:
Telephone Number	:	662-303-3102

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	02/19/2015

Similar Medicare Providers

1174543607 — JUNCTION CITY USD 475
Practice Location Address:

123 N EISENHOWER DR
JUNCTION CITY, KS
66441-3313

Practice Phone: 785-717-4000
Practice Fax: 785-717-4002

1194012849 — MRS. MEGAN ANNE GFELLER MS, CCC-SLP/L
Practice Location Address:

123 N EISENHOWER DR
JUNCTION CITY, KS
66441-3313

Practice Phone: 785-717-4136
Practice Fax: 785-717-4217

1679971717 — CHALLEY FULLAGAR
Practice Location Address:

123 N EISENHOWER DR
JUNCTION CITY, KS
66441-3313

Practice Phone: 785-717-4130
Practice Fax:

1447572631 — LUCY XI LIU
Practice Location Address:

3313 JUNCTION BLVD
JACKSON HEIGHTS, NY
11372

Practice Phone: 718-507-6800
Practice Fax:

1225341274 — HEALTH GUARD PHARMACY INC.
Practice Location Address:

3313 JUNCTION BLVD
JACKSON HEIGHTS, NY
11372-2031

Practice Phone: 718-507-6800
Practice Fax: 347-649-1861

1629407630 — ELIZABETH CLOUGHEN
Practice Location Address:

3313 JUNCTION BLVD
JACKSON HEIGHTS, NY
11372-2031

Practice Phone: 718-507-6800
Practice Fax:

Directions to “PROCARE THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.