Individual
DMITRIY MASHKARUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 15TH ST, WHEATLAND, WY 82201-3224
(307) 322-6406
Mailing address
4251 KIPLING ST UNIT 340, WHEAT RIDGE, CO 80033-2898
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1221
NE
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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