| NPI | 1649494824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT KAUFMAN Administrator 307-745-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2009-06-11 |