Healthcare Provider Details

I. General information

NPI: 1962894451
Provider Name (Legal Business Name): OPTIMAL PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 S POPLAR ST
CASPER WY
82601-6104
US

IV. Provider business mailing address

4120 S POPLAR ST
CASPER WY
82601-6104
US

V. Phone/Fax

Practice location:
  • Phone: 307-262-7006
  • Fax:
Mailing address:
  • Phone: 307-262-7006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1140
License Number StateWY

VIII. Authorized Official

Name: DR. JEREMY EDWARD BIEBER
Title or Position: OWNER
Credential: DPT
Phone: 307-262-7006