Organization
PRO-MOTION CHIROPRACTIC AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH PAUL HANDSCHIN D.C. (OWNER)
(307) 699-3170
Entity
Organization
Contact information
Practice address
4030 W LAKE CREEK DR, STE. 9, WILSON, WY 83014-9689
(307) 699-3170
Mailing address
PO BOX 12743, JACKSON, WY 83002-2743
(307) 699-3170
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
681
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W24372
PTAN
WY
Enumeration date
09/21/2009
Last updated
04/23/2012
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