| NPI | 1801386370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CAROL CALLAWAY Office Manager 307-670-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1435) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |