Healthcare Provider Details

I. General information

NPI: 1598684268
Provider Name (Legal Business Name): ALAINA ELISE FAUBER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W HESSE ST
BUFFALO WY
82834-1501
US

IV. Provider business mailing address

PO BOX 68
KAYCEE WY
82639-0068
US

V. Phone/Fax

Practice location:
  • Phone: 307-621-0935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA-1083
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: