MEDICARE: JEAN M. GUY P.T.

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
1	225100000X	Physical Therapist	PT-833	WY

General Provider Information

NPI Number	:	1588761522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN M. GUY P.T.

Provider Business Mailing Address
First Line	:	920 UPLAND WAY
Second Line	:
City	:	GREEN RIVER
State	:	WY
Zip	:	82935-6064
Country	:	US
Telephone Number	:	307-875-1847
Fax Number	:	307-875-4269

Provider Business Practice Location Address
First Line	:	920 UPLAND WAY
Second Line	:
City	:	GREEN RIVER
State	:	WY
Zip	:	82935-6064
Country	:	US
Telephone Number	:	307-875-1847
Fax Number	:	307-875-4269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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Directions to “ JEAN M. GUY P.T.” Practice Location

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