Individual
KERRY A BREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1977 DEWAR DR STE J, ROCK SPRINGS, WY 82901-5757
(307) 382-3228
Mailing address
1977 DEWAR DR STE J, ROCK SPRINGS, WY 82901-5757
(307) 382-3228
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-853
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117566100
—
WY
01
—
179483
WORK COMP
WA
01
—
315268
BLUE CROSS BLUE SHIELD
WY
Enumeration date
09/29/2006
Last updated
08/11/2020
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