| NPI | 1023553971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BLAIR PT/Owner 307-340-1573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305207779) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2017-01-02 |