| NPI | 1295481174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY JOHNSON Owner 307-670-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-05-23 |