Organization
ACTIVE BALANCE PHYSICAL THERAPY, LLC
Active
Organization
ACTIVE BALANCE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA K STUTZMAN PT (PRESIDENT)
(307) 655-2509
Entity
Organization
Contact information
Practice address
512 MAIN ST, DAYTON, WY 82836-5056
(307) 655-2509
(370) 655-2275
Mailing address
PO BOX 1064, DAYTON, WY 82836-1064
(307) 655-2509
(307) 655-2275
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-0964
WY
Other
Enumeration date
11/10/2015
Last updated
02/01/2023
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