| NPI | 1386170959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE CHRISTINE LANSANG Owner 307-389-8661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1494) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2026-03-09 |