| NPI | 1003257601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L MAZUR Owner 307-335-3471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WY OTR-814) |
| 2251X0800X Physical Therapist, Orthopedic | |
| 225XE1200X Occupational Therapist, Ergonomics (Licence: WY OTR-814) | |
| 225XH1200X Occupational Therapist, Hand (Licence: WY OTR-814) | |
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: WY OTR-814) | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: WY OTR-814) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: WY OTR-814) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-12-09 |