Mr David Matthew Johnson, MSPT | |
124 Petersen Parkway #6, Suite 1, Thayne, WY 83127 | |
(307) 883-7878 | |
(307) 883-7877 |
Full Name | Mr David Matthew Johnson |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 124 Petersen Parkway #6, Thayne, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851314785 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 1167 (Wyoming) | Primary |
Provider Name | North Lincoln County Hospital District |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1730132523 PECOS PAC ID: 4789580218 Enrollment ID: O20031208000415 |
Mailing Address | Practice Location Address |
---|---|
Mr David Matthew Johnson, MSPT 124 Petersen Parkway, #6, Thayne, WY 83127 Ph: (307) 883-9632 | Mr David Matthew Johnson, MSPT 124 Petersen Parkway #6, Suite 1, Thayne, WY 83127 Ph: (307) 883-7878 |
Dr. Hayden Glen Datwyler, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 124 Petersen Pkwy, Thayne, WY 83127 Phone: 307-883-7878 | |
Jimmy Douglas Wheeler, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 124 Petersen Parkway, #1, Thayne, WY 83127 Phone: 307-883-7878 Fax: 307-883-7877 | |
Dr. Kevin Baldwin, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 124 Petersen Pkwy, Thayne, WY 83127 Phone: 307-883-7878 Fax: 307-883-7877 | |
Kenneth Smith, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 487a North Main St, Thayne, WY 83127 Phone: 307-883-8877 Fax: 307-883-8876 | |
Dr. Clancy Clyde Brown, DPT, CSCS Physical Therapist Medicare: Medicare Enrolled Practice Location: 124 Petersen Pkwy Ste 1, Thayne, WY 83127 Phone: 307-883-7878 Fax: 307-883-7877 | |
Daniel Dean Jeske, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 124 Petersen Parkway #1, Thayne, WY 83127 Phone: 307-883-7878 | |
David Stoker, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 487a N Main St, Thayne, WY 83127 Phone: 307-883-8877 Fax: 307-883-8876 |