Provider Demographics
NPI:1912497215
Name:ENGLING, MICHAEL COLE (PT, DPT, LAT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:COLE
Last Name:ENGLING
Suffix:
Gender:M
Credentials:PT, DPT, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 W LOTT ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-1658
Mailing Address - Country:US
Mailing Address - Phone:307-684-6276
Mailing Address - Fax:307-684-6258
Practice Address - Street 1:268 NOLAN AVE.
Practice Address - Street 2:
Practice Address - City:KAYCEE
Practice Address - State:WY
Practice Address - Zip Code:82639
Practice Address - Country:US
Practice Address - Phone:307-738-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist