Individual
THERESA SHOEMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
545 E MAIN ST STE B, LANDER, WY 82520-3470
(307) 335-3471
Mailing address
1406 W MAIN ST, RIVERTON, WY 82501-3239
(307) 857-7074
(307) 856-6459
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12903
CO
225100000X
Physical Therapist
Primary
PT-1724
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12903
MEDICARE
CO
05
—
154606600
—
WY
Enumeration date
08/22/2014
Last updated
08/06/2024
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