Organization
OCCUPATIONAL THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL DIANE DAVIS OTR/L (OCCUPATIONAL THERAPIST)
(307) 677-0669
Entity
Organization
Contact information
Practice address
612 COUNTRY CLUB DR, EVANSTON, WY 82930-3252
(307) 677-0669
Mailing address
612 COUNTRY CLUB DR, EVANSTON, WY 82930-3252
(307) 677-0669
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OTR-509
WY
Other
Enumeration date
01/09/2016
Last updated
01/09/2016
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