Dmitriy Mashkaruk
Individual provider Active NPI Physical Therapy Assistant · Wheatland, WY
NPI 1922428010 · NPPES record last updated Apr 16, 2014
Key facts
- NPI
- 1922428010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1221 (NE)
- Practice address
- 204 15TH St
Wheatland, WY 82201-3224 - Phone
- (307) 322-6406
- NPI assigned
- Apr 16, 2014
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1221 | NE | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1221 | NE | Yes |
Addresses
Primary practice location
204 15TH St
Wheatland, WY 82201-3224
Mailing address
4251 Kipling St Unit 340
Wheat Ridge, CO 80033-2898
Other providers in Wheatland, WY
- Joshua Arlan Madsen
- Kari Magnuson
- Lacy R Mansfield
- Stephanie Marker
- Tambreah Martin
- Jessica McCall
- Krystal Leeann McClain
- Alexis Nicole Medrano
- Memorial Hospital of Converse County
- Memorial Hospital of Laramie County
All providers in Wheatland, 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 Apr 16, 2014. 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.