| NPI | 1144598491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY D GARDNER Owner/Supervisor 307-752-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT 1154) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2012-10-25 |