Healthcare Provider Details

I. General information

NPI: 1922444744
Provider Name (Legal Business Name): VALLEY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 RIVER STREET
SARATOGA WY
82331
US

IV. Provider business mailing address

PO BOX 668
SARATOGA WY
82331-0668
US

V. Phone/Fax

Practice location:
  • Phone: 307-256-8846
  • Fax: 307-326-8106
Mailing address:
  • Phone: 307-256-8846
  • Fax: 307-326-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number833
License Number StateWY

VIII. Authorized Official

Name: JEAN MICHELLE GUY
Title or Position: SOLE PROPRIETOR
Credential: PT
Phone: 307-256-8846