| NPI | 1326062852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L VILLA Office Manager 307-431-2414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-297) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2008-10-01 |