Christine Larae Gordon, PTA
Individual provider Active NPI Physical Therapy Assistant · Casper, WY
NPI 1699475772 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1699475772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA-0537 (WY)
- Practice address
- 60 Magnolia St
Casper, WY 82604-4035 - Phone
- (307) 234-9381
- NPI assigned
- Mar 7, 2023
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-0537 | WY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA-0537 | WY | Yes |
Addresses
Primary practice location
60 Magnolia St
Casper, WY 82604-4035
Mailing address
12105 Zero Rd
Casper, WY 82604-9541
Phone (307) 277-2534
Other providers in Casper, WY
- Kelcie Goham
- Alex Golde
- Monica Gonzales
- Katie Goode
- Danielle Goodwin
- Kyle David Gordon
- Matthew Gorman
- Henry P Gottsch
- Aimee E Gough
- Grace Family Practice, LLC
All providers in Casper, 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 Mar 7, 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.