Organization
BLACKS FORK PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY S. STOKES PT (PHYSICAL THERAPIST/OWNER)
(307) 679-4959
Entity
Organization
Contact information
Practice address
195 FEATHER WAY, EVANSTON, WY 82930-9352
(307) 679-4959
Mailing address
3792 ALMY ROAD 107, EVANSTON, WY 82930-8940
(307) 679-4959
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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