Individual
THAD JUSTIN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2002 W SUNSET DR, SUITE 1, RIVERTON, WY 82501-2283
(307) 856-7021
(307) 856-5546
Mailing address
2002 W SUNSET DR, SUITE 1, RIVERTON, WY 82501-2283
(307) 856-7021
(307) 856-5546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1633
WY
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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