| NPI | 1386170959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE LANSANG Owner 307-382-8661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WY 1494) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2019-07-24 |