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1063009272
SPORTS AND REHABILITATION CENTER OF WYOMING LLC
JACKSON, WY
NPI
1063009272
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Entity Type
Organization
Authorized Contact
AUSTIN HAMMESFAHR
Manager
310-307-9670
Organization Subpart ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2020-12-22
Last Update Date
2021-05-23
Business Address
SPORTS AND REHABILITATION CENTER OF WYOMING LLC
625 E BROADWAY AVE
JACKSON, WY 83001-8642
Phone number: 307-920-1688
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Mailing Address
SPORTS AND REHABILITATION CENTER OF WYOMING LLC
522 N SWEETZER AVE APT 5
LOS ANGELES, CA 90048-2659
Phone number: 310-307-9670
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