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General NPI Number Information
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NPI Number | 1205631629
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Entity Type | Organization
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Legal Business Name | WEST BANK PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 4010 W LAKE CREEK DR
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City | WILSON
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State | WY
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Zip | 83014-9202
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Country | US
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Telephone | 307-203-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 6671 MUSTANG TRL
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City | VICTOR
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State | ID
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Zip | 83455-4801
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Country | US
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Telephone | 307-413-5415
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | ERIN DOWNEY
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Credential | DPT
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Telephone | 307-413-5415
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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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