Organization
WIND RIVER PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TY NATHANIEL FRANCIS MPT (OWNER)
(307) 335-5188
Entity
Organization
Contact information
Practice address
150 LINCOLN ST, LANDER, WY 82520-2846
(307) 335-5188
(307) 333-0600
Mailing address
364 NORTH 2ND STREET, LANDER, WY 82520-3033
(307) 335-5188
(307) 333-0600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
WY-1202
WY
Other
Enumeration date
07/18/2014
Last updated
02/02/2015
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