| NPI | 1366493264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MANGUS CFO 307-358-9464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2015-11-10 |