Lance Krunosky, LPTA

Individual provider Active NPI Physical Therapy Assistant · Douglas, WY

NPI 1134044845 · NPPES record last updated Aug 11, 2026

Key facts

NPI
1134044845
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
12497 (AL)
Practice address
111 S 5TH St
Douglas, WY 82633-2434
Phone
(307) 358-9464
Fax
(307) 358-9330
NPI assigned
Aug 11, 2026
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 12497 AL Yes

Addresses

Primary practice location

111 S 5TH St
Douglas, WY 82633-2434

Mailing address

5830 Granite Pkwy Ste 800
Plano, TX 75024-6775
Phone (469) 694-0660

Other providers in Douglas, WY

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

Sources for this page

Verify at the official NPI Registry.