Organization
FOUR PINES PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA NORENE CHRISTENSEN PT MS OCS (OWNER PRESIDENT)
(307) 733-5577
Entity
Organization
Contact information
Practice address
1090 S HWY 89, JACKSON, WY 83001
(307) 733-5577
(307) 733-5505
Mailing address
PO BOX 8467, JACKSON, WY 83002-8467
(307) 733-5577
(307) 733-5505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113731000
—
WY
01
—
307976
BCBS
WY
Enumeration date
10/21/2006
Last updated
11/29/2011
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