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General NPI Number Information
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NPI Number | 1962894451
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Entity Type | Organization
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Legal Business Name | OPTIMAL PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 4120 S POPLAR ST
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City | CASPER
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State | WY
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Zip | 82601-6104
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Country | US
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Telephone | 307-262-7006
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 S POPLAR ST
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City | CASPER
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State | WY
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Zip | 82601-6104
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Country | US
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Telephone | 307-262-7006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEREMY EDWARD BIEBER
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Credential | DPT
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Telephone | 307-262-7006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1140
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License Number State | WY
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