Cassidy R Drevlow, DPT | |
1013 E Boxelder Rd Ste 100, Gillette, WY 82718-5936 | |
(307) 682-4900 | |
Not Available |
Full Name | Cassidy R Drevlow |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 1013 E Boxelder Rd Ste 100, Gillette, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023736089 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT-2196 (Wyoming) | Primary |
Provider Name | Gillette Physical Therapy Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1154379998 PECOS PAC ID: 0345282570 Enrollment ID: O20050526000791 |
Mailing Address | Practice Location Address |
---|---|
Cassidy R Drevlow, DPT 2600 Dallas Pkwy Ste 290, Frisco, TX 75034-7493 Ph: (945) 260-0010 | Cassidy R Drevlow, DPT 1013 E Boxelder Rd Ste 100, Gillette, WY 82718-5936 Ph: (307) 682-4900 |
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