Individual
NANCY A ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2121 E 2ND ST STE 100, CASPER, WY 82609-2056
(307) 333-4923
Mailing address
2121 E 2ND ST STE 100, CASPER, WY 82609-2056
(307) 333-4923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-378
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113699200
—
WY
01
—
305364
BCBS
WY
01
—
P00188594
RR MEDICARE
WY
Enumeration date
08/12/2005
Last updated
10/18/2017
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