| NPI | 1841717410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE CHILDS EVERETT Physical Therapist/Owner 307-421-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 0984) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: WY 0984) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |