Organization
BEARTOOTH PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY D GARDNER MS, DPT (OWNER/SUPERVISOR)
(307) 752-9335
Entity
Organization
Contact information
Practice address
1333 W 5TH ST, SUITE 203, SHERIDAN, WY 82801-2752
(307) 752-9335
Mailing address
PO BOX 306, BIG HORN, WY 82833-0306
(307) 752-9335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1154
WY
Other
Enumeration date
12/01/2011
Last updated
10/25/2012
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