| Wyoming Specialized Physical Therapy Inc. | |
|
620 W Cheyenne Dr., Evanston, WY 82930-5505 | |
| (307) 789-8860 | |
| (307) 789-8394 |
| Full Name | Wyoming Specialized Physical Therapy Inc. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 620 W Cheyenne Dr., Evanston, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336151265 | NPI | - | NPPES |
| 118279000 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Secondary |
| Provider Name | Michael G Jacketta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134131055 PECOS PAC ID: 8426043167 Enrollment ID: I20101122000809 |
| Provider Name | Brian D Redden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689989055 PECOS PAC ID: 7517198161 Enrollment ID: I20140324001104 |
| Provider Name | Matt T Lowell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811022148 PECOS PAC ID: 3375839202 Enrollment ID: I20160901001052 |
| Provider Name | Carol D Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437515285 PECOS PAC ID: 1850698218 Enrollment ID: I20170808003710 |
| Provider Name | Devin J Orrock |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497313563 PECOS PAC ID: 2365777398 Enrollment ID: I20190715000522 |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Specialized Physical Therapy Inc. 620 W Cheyenne Dr., Evanston, WY 82930-5505 Ph: (307) 789-8860 | Wyoming Specialized Physical Therapy Inc. 620 W Cheyenne Dr., Evanston, WY 82930-5505 Ph: (307) 789-8860 |
The Intuitive Parents Physical Therapy Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 350 City View Dr Ste 204, Evanston, WY 82930 Phone: 307-223-2286 Fax: 307-448-4604 | |
Michael Gene Jacketta, MPT, OCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 620 West Cheyenne Drive, Evanston, WY 82930 Phone: 307-789-8860 Fax: 307-789-8394 | |
Talen Little, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 195 Feather Way, Evanston, WY 82930 Phone: 307-224-7940 | |
Uinta Physical Therapy, Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 170 Yellow Creek Rd, Suite D, Evanston, WY 82930 Phone: 307-783-8068 Fax: 307-783-8073 | |
Dr. Jacqueline Clark, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 195 Feather Way, Evanston, WY 82930 Phone: 307-789-0096 | |
Dr. Matthew Dennis Mitchell, PT, DPT, OCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 196 Arrowhead Dr Ste 3, Evanston, WY 82930 Phone: 307-783-8220 |