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General NPI Number Information
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NPI Number | 1164378832
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Entity Type | Organization
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Legal Business Name | WILD STRENGTH PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 730 LINCOLN ST
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City | LANDER
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State | WY
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Zip | 82520-2734
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Country | US
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Telephone | 801-949-8005
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BOULDER LOOP
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City | LANDER
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State | WY
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Zip | 82520-9626
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Country | US
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Telephone | 801-949-8005
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | JASON WEST
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Credential | PT, MPT
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Telephone | 801-949-8005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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