Organization
JACKSON HOLE SPORTS RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIANNA RISOLI PT (PHYSICAL THERAPIST, OWNER)
(307) 439-4257
Entity
Organization
Contact information
Practice address
680 S CACHE ST STE 100, JACKSON, WY 83001-8694
(307) 439-4247
Mailing address
PO BOX 880, JACKSON, WY 83001-0880
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2020
Last updated
08/31/2020
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