Individual
SKYLER WILLIAM JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1102 W SPRUCE ST, RAWLINS, WY 82301-5335
(307) 370-9175
Mailing address
201 LA PALOMA DR, RAWLINS, WY 82301-5111
(308) 627-4908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1878
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-1878
STATE LICENSE
WY
Enumeration date
07/05/2019
Last updated
07/05/2019
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