Organization
NEW VISION REHABILITATION
Active
Organization
NEW VISION REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRISTOPHER ALLISON (MEMBER)
(307) 699-7478
Entity
Organization
Contact information
Practice address
120 WEST PEARL AVE, JACKSON, WY 83001
(307) 699-7478
Mailing address
PO BOX 9698, JACKSON, WY 83002-9698
(307) 699-7478
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR-699
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12627042
CAQH
WY
Enumeration date
12/09/2013
Last updated
12/09/2013
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