Provider Demographics
NPI:1649428012
Name:SPILLMAN, DANA (DPT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SPILLMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:BUGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:520 WILKES DR STE 17
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-4854
Mailing Address - Country:US
Mailing Address - Phone:307-875-1788
Mailing Address - Fax:307-875-8817
Practice Address - Street 1:520 WILKES DR STE 17
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935
Practice Address - Country:US
Practice Address - Phone:307-875-1788
Practice Address - Fax:307-875-8811
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist