Healthcare Provider Details
I. General information
NPI: 1700081239
Provider Name (Legal Business Name): ALLIANCE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2007
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1977 DEWAR DR J
ROCK SPRINGS WY
82901-5737
US
IV. Provider business mailing address
PO BOX 1244
MOUNTAIN VIEW WY
82939-1244
US
V. Phone/Fax
- Phone: 307-382-3228
- Fax: 307-382-6886
- Phone: 307-705-3300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAREN
L
MARTIN
Title or Position: OWNER
Credential: MPT
Phone: 307-382-3228