| NPI | 1164949095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE MARIE SHEAMANSMITH Owner 307-635-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1287) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2020-05-19 |