Leo Shane Sanchez, PTA

Individual provider Active NPI Physical Therapy Assistant · Cheyenne, WY

NPI 1982121752 · NPPES record last updated Aug 23, 2017

Key facts

NPI
1982121752
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0841 (WY)
Practice address
820 Sun Valley Dr
Cheyenne, WY 82001-6850
Phone
(307) 477-0176
NPI assigned
Aug 23, 2017
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

LicenseStateTypeSpecialty
0841WYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0841 WY Yes

Addresses

Primary practice location

820 Sun Valley Dr
Cheyenne, WY 82001-6850

Mailing address

820 Sun Valley Dr
Cheyenne, WY 82001-6850

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.