Organization
WYOMING PHYSICAL THERAPY PC
Active
Other names
Brookside Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER WILSON (OWNER)
(720) 223-6177
Entity
Organization
Contact information
Practice address
1217 S GREELEY HWY, SUITE A, CHEYENNE, WY 82007-3034
(307) 772-0955
(307) 772-0953
Mailing address
1217 S GREELEY HWY, SUITE A, CHEYENNE, WY 82007-3034
(307) 772-0955
(307) 772-0953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114492800
—
WY
Enumeration date
12/18/2006
Last updated
12/11/2023
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