Melissa Gardner, PTA
Individual provider Active NPI Physical Therapy Assistant · Worland, WY
NPI 1053079103 · NPPES record last updated Dec 6, 2021
Key facts
- NPI
- 1053079103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA300 (WY)
- Practice address
- 1901 Howell Ave
Worland, WY 82401-3733 - Phone
- (307) 347-4285
- NPI assigned
- Dec 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA300 | WY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA300 | WY | Yes |
Addresses
Primary practice location
1901 Howell Ave
Worland, WY 82401-3733
Mailing address
PO Box 374
Riverton, WY 82501-0075
Phone (307) 851-0859
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0859 | Medicaid | WY |
Other providers in Worland, WY
- Lynn Fritzler
- Frontier Family Practice LLC
- Jose Galarza
- Brandon Galovich
- Megan Galovich
- Roberta D Gentile
- George G. Richardson MD PC
- Gerald E Weaver MD PC
- Lonnie G Gerharter
- James A Gilman
All providers in Worland, WY · Physical Therapy Assistant in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.