Mary Ellen Honeycutt, PTA
Individual provider Active NPI Physical Therapy Assistant · Lander, WY
NPI 1346931342 · NPPES record last updated May 19, 2023
Key facts
- NPI
- 1346931342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A4586 (LA)
- Practice address
- 760 Canyon St Apt 2
Lander, WY 82520-3251 - Phone
- (337) 912-1249
- NPI assigned
- May 19, 2023
- 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 |
|---|---|---|---|
| A4586 | LA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A4586 | LA | Yes |
Addresses
Primary practice location
760 Canyon St Apt 2
Lander, WY 82520-3251
Mailing address
PO Box 567
Lander, WY 82520-0567
Phone (337) 912-1249
Other providers in Lander, WY
- Michael Ross Holland
- Todd Gunnar Holmes
- Ken V Holt
- Ellen K Holzmann
- Home Life Care, LLC
- Kenneth Hooper Jr.
- Ross Hopeman Hopeman
- Emily Marie Horne
- Maegen Horton
- Terrance Hubenka
All providers in Lander, 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 May 19, 2023. 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.