Provider Demographics
NPI:1386663813
Name:ZEISS, MARGARET A (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:ZEISS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:DUBOIS
Mailing Address - State:WY
Mailing Address - Zip Code:82513-0775
Mailing Address - Country:US
Mailing Address - Phone:307-455-3292
Mailing Address - Fax:307-455-3339
Practice Address - Street 1:1403 WEST RAMSHORN
Practice Address - Street 2:SUITE 5
Practice Address - City:DUBOIS
Practice Address - State:WY
Practice Address - Zip Code:82513
Practice Address - Country:US
Practice Address - Phone:307-455-3292
Practice Address - Fax:307-455-3339
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT - 747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY116399000Medicaid
WY9104Medicare ID - Type Unspecified