Organization
TETON HAND THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA C GRIGGS OTR, CHT (DIRECTOR, MANAGER)
(307) 734-2877
Entity
Organization
Contact information
Practice address
310 EAST BROADWAY, JACKSON, WY 83001-0000
(307) 734-2877
Mailing address
PO BOX 4596, JACKSON, WY 83001-4596
(307) 734-2877
(307) 734-2827
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
OT059
WY
332BC3200X
Customized Equipment (DME)
Primary
OT059
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122059400
—
WY
01
—
785001
BLUE SHIELD GROUP
WY
Enumeration date
05/09/2007
Last updated
10/23/2012
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