Organization
SKY PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN VAN HATTEN PT, OCS (OWNER)
(307) 733-7173
Entity
Organization
Contact information
Practice address
970 W BROADWAY, JACKSON, WY 83001-9475
(307) 733-7173
Mailing address
PO BOX 9163, JACKSON, WY 83002-9163
(307) 733-7173
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
325
WY
Other
Enumeration date
09/12/2007
Last updated
09/09/2009
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