Organization
IMPACT PHYSICAL THERAPY LLC
Active
Other names
Impact Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DENNIS DPT (OWNER)
(801) 209-4466
Entity
Organization
Contact information
Practice address
96 YELLOW CREEK ROAD, EVANSTON, WY 82930
(307) 444-4466
(307) 444-4468
Mailing address
96 YELLOW CREEK ROAD, EVANSTON, WY 82930
(307) 444-4466
(307) 444-4468
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
PT 1683
WY
261QP2000X
Physical Therapy Clinic/Center
Primary
PT1568
WY
Other
Enumeration date
07/18/2015
Last updated
02/13/2017
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