Organization
PROACTIVE PHYSICAL THERAPY PC
Active
Other names
Proactive Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M HOLZ DPT (OWNER PHYSICAL THERAPIST)
(307) 367-6236
Entity
Organization
Contact information
Practice address
317 N FALER AVE, PINEDALE, WY 82941
(307) 367-6236
(307) 367-3332
Mailing address
PO BOX 1037, PINEDALE, WY 82941-1037
(307) 367-6236
(307) 367-3332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1163001
BLUE CROSS BLUE SHIELD
WY
Enumeration date
07/25/2007
Last updated
08/22/2020
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