Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Wanserski, DPT

Individual provider Physical Therapist · NPI 1619563863

Mallory Wanserski, DPT is a Physical Therapist in Private Practice in Frisco, Colorado. Qualified in 2020, 6 years ago. Practices with Axis Sports Medicine LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Colorado and Wisconsin.

Years since qualifying
6
Licensed in
CO, WI
In the registry since
2020
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

710 N Summit Blvd Unit 103
Frisco, CO 80443-5666
Phone: (970) 368-6908
Fax: (970) 368-6910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 0017354 (CO)
Physical Therapist Taxonomy 225100000X · Licence 15240-24 (WI)

Record details

NPI number1619563863
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedDecember 11, 2020
Last updated in NPPESDecember 11, 2020
Certification dateDecember 11, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Axis Sports Medicine Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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