Organization
AVENUES PHYSICAL THERAPY INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALYNN C SMITH LPT (PRESIDENT)
(307) 634-0298
Entity
Organization
Contact information
Practice address
611 W 18TH ST, CHEYENNE, WY 82001-4304
(307) 634-0298
(307) 634-0837
Mailing address
611 W 18TH ST, CHEYENNE, WY 82001-4304
(307) 634-0298
(307) 634-0837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
160
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107090800
—
WY
Enumeration date
09/20/2006
Last updated
11/19/2019
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