| Tanner Spade, DPT, OCS, SCS | |
|
109 W Hesse St, Buffalo, WY 82834-1501 | |
| (307) 621-0935 | |
| (844) 409-0424 |
| Full Name | Tanner Spade |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 109 W Hesse St, Buffalo, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659961845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-1715 (Wyoming) | Primary |
| Provider Name | Black Tooth Physiotherapy and Performance, LLC |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1306708557 PECOS PAC ID: 3577034685 Enrollment ID: O20260609002128 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner Spade, DPT, OCS, SCS 109 W Hesse St, Buffalo, WY 82834-1501 Ph: (307) 621-0935 | Tanner Spade, DPT, OCS, SCS 109 W Hesse St, Buffalo, WY 82834-1501 Ph: (307) 621-0935 |
Philip Francis Milton Henry, DPT, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 38 N Desmet Ave Ste 2, Buffalo, WY 82834 Phone: 307-278-0256 Fax: 307-278-0289 |
Brittany Miskimins, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 93 Bighorn Dr, Buffalo, WY 82834 Phone: 307-217-3781 |
Marye Carlson, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 497 W Lott St, Buffalo, WY 82834 Phone: 307-684-6172 |
Remount Physical Therapy, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 93 Bighorn Dr, Buffalo, WY 82834 Phone: 307-217-3781 |
Krista Lane Lausen, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 509 Fort St Ste B, Buffalo, WY 82834 Phone: 307-684-8623 Fax: 307-684-8623 |
Mrs. Cathy Monique Miner, M.S.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 164 W Hart St, Buffalo, WY 82834 Phone: 307-684-8623 |
Buffalo Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 509 Fort St Ste B, Buffalo, WY 82834 Phone: 307-684-8623 Fax: 307-684-8623 |