Grant A Basko, | |
820 W Main St, Riverton, WY 82501-3342 | |
(307) 857-7074 | |
(307) 856-6459 |
Full Name | Grant A Basko |
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Gender | Male |
Speciality | Occupational Therapist |
Location | 820 W Main St, Riverton, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255666137 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OTR-763 (Wyoming) | Primary |
Provider Name | William H And Carrie Gottsche Foundation |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1558319392 PECOS PAC ID: 5092606293 Enrollment ID: O20040324001113 |
Mailing Address | Practice Location Address |
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Grant A Basko, Po Box 2400, Rock Springs, WY 82902-2400 Ph: (307) 362-4336 | Grant A Basko, 820 W Main St, Riverton, WY 82501-3342 Ph: (307) 857-7074 |
Kelly Yuhnke, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1202 E Jackson Ave, Riverton, WY 82501 Phone: 307-856-4337 | |
Keely E Tatro, OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 820 W Main St, Riverton, WY 82501 Phone: 307-857-7074 Fax: 307-856-6459 | |
Mrs. Sarah Michelle Hancock, O.T. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 121 N 5th St. W, To Career Center, Riverton, WY 82501 Phone: 307-921-9546 | |
Miss Brenda Jo Walker, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1202 E Jackson Ave, Riverton, WY 82501 Phone: 307-856-4337 Fax: 307-856-0851 | |
Holly Caprice Allen, GED Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1022 E Roosevelt Ave, Riverton, WY 82501 Phone: 307-851-5178 | |
Susan Jean Wright, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1002 Forest Dr, Riverton, WY 82501 Phone: 307-856-1511 Fax: 307-856-1792 |