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General NPI Number Information
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NPI Number | 1639219983
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Entity Type | Organization
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Legal Business Name | THERAPY WORKS LLC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 03/28/2016
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Provider Practice Location Address
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Address Line | 487A N MAIN ST
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City | THAYNE
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State | WY
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Zip | 83127
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Country | US
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Telephone | 307-883-8877
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Fax | 307-883-8876
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Provider Business Mailing Address
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Address Line | PO BOX 860 487A N MAIN ST
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City | THAYNE
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State | WY
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Zip | 83127-0860
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Country | US
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Telephone | 307-883-8877
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Fax | 307-883-8876
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Authorized Official
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Title or Position | OWNER
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Name | MR. ERIC BOONE HODGES
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Credential | OT
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Telephone | 307-887-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR-538
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License Number State | WY
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