Leigh Vantassel, PTA

Individual provider Active NPI Physical Therapy Assistant · Casper, WY

NPI 1124144191 · NPPES record last updated Dec 7, 2010

Key facts

NPI
1124144191
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA-398 (WY)
Practice address
6631 E 2ND St
Casper, WY 82609-4355
Phone
(307) 268-9904
Fax
(307) 268-9907
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA-398WYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-398 WY Yes

Addresses

Primary practice location

6631 E 2ND St
Casper, WY 82609-4355

Mailing address

6631 E 2ND St
Casper, WY 82609-4355
Phone (307) 268-9904

Other providers in Casper, WY

All providers in Casper, WY · Physical Therapy Assistant in Wyoming

Sources for this page

Verify at the official NPI Registry.