| NPI | 1962894451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY EDWARD BIEBER Owner 307-262-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WY 1140) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2020-08-17 |