| Jessica Rae Fahsholtz, | |
|
1406 W Main St, Riverton, WY 82501-3239 | |
| (307) 857-7074 | |
| (307) 856-6459 |
| Full Name | Jessica Rae Fahsholtz |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1406 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 |
|---|---|---|---|
| 1548091051 | NPI | - | NPPES |
| OT-1811 | Other | WY | OCCUPATIONAL THERAPIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT-1811 (Wyoming) | Primary |
| Provider Name | Teton Therapy Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1275564122 PECOS PAC ID: 3971586199 Enrollment ID: O20040609001076 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Rae Fahsholtz, 1406 W Main St, Riverton, WY 82501-3239 Ph: (307) 463-0462 | Jessica Rae Fahsholtz, 1406 W Main St, Riverton, WY 82501-3239 Ph: (307) 857-7074 |
Kelly Yuhnke, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1202 E Jackson Ave, Riverton, WY 82501 Phone: 307-856-4337 | |
Grant A Basko, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 820 W Main St, Riverton, WY 82501 Phone: 307-857-7074 Fax: 307-856-6459 | |
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: Medicare Enrolled 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 |