Lisa Joy Landa, P.T.A.

Individual provider Active NPI Physical Therapy Assistant · Rawlins, WY

NPI 1669633434 · NPPES record last updated Jun 24, 2008

Key facts

NPI
1669633434
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA-0129 (WY)
Practice address
1115 13TH St
Rawlins, WY 82301-4610
Phone
(307) 324-5061
NPI assigned
Jun 24, 2008
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-0129WYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-0129 WY Yes

Addresses

Primary practice location

1115 13TH St
Rawlins, WY 82301-4610

Mailing address

PO Box 1262
Rawlins, WY 82301-1262
Phone (307) 324-5061

Other providers in Rawlins, WY

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

Sources for this page

Verify at the official NPI Registry.