| NPI | 1356483945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BAROODY Office Mgr 307-577-0402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT 77) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT 202) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |