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General NPI Number Information
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NPI Number | 1790431674
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Entity Type | Organization
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Legal Business Name | HAND THERAPY OF WYOMING DOUGLAS/CASPER
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 102 BROWNFIELD RD
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City | DOUGLAS
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State | WY
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Zip | 82633-2555
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Country | US
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Telephone | 307-670-9191
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Fax | 307-670-9193
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Provider Business Mailing Address
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Address Line | 1211 S DOUGLAS HWY STE 100
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City | GILLETTE
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State | WY
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Zip | 82716-4982
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Country | US
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Telephone | 307-685-3375
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY SIEFERT
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Credential | MOTR/L
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Telephone | 307-756-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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