Amanda M Krov, PTA

Individual provider Active NPI Physical Therapy Assistant · Cheyenne, WY

NPI 1407106917 · NPPES record last updated Sep 12, 2012

Key facts

NPI
1407106917
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0760 (WY)
Practice address
3352 Dunn Ave
Cheyenne, WY 82001-1535
Phone
(307) 421-1154
NPI assigned
Sep 12, 2012
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

LicenseStateTypeSpecialty
0760WYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0760 WY Yes

Addresses

Primary practice location

3352 Dunn Ave
Cheyenne, WY 82001-1535

Mailing address

3352 Dunn Ave
Cheyenne, WY 82001-1535

Other providers in Cheyenne, WY

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

Sources for this page

Verify at the official NPI Registry.