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NPI Code Detail

MEDICARE: OPTIMAL PHYSICAL THERAPY, LLC

MEDICARE: OPTIMAL PHYSICAL THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1063340891
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMAL PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 4120 S POPLAR ST
Second Line :
City : CASPER
State : WY
Zip : 82601-6104
Country : US
Telephone Number : 307-333-2873
Fax Number : 307-333-4034
Provider Business Practice Location Address
First Line : 4270 S POPLAR ST
Second Line :
City : CASPER
State : WY
Zip : 82601-6105
Country : US
Telephone Number : 307-333-6200
Fax Number : 307-333-5880
Authorized Official
Title or Position : CEO
Name : JEREMY BIEBER
Credential : PT,DPT,OCS
Telephone Number : 307-333-2873
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “OPTIMAL PHYSICAL THERAPY, LLC ” Practice Location

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