Organization
EAGLE RIDGE REHABILITATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESREE LYNN SMITH (CHIEF EXECUTIVE OFFICER)
(307) 751-7588
Entity
Organization
Contact information
Practice address
437 SHADOW RIDGE BLVD, SHERIDAN, WY 82801-9350
(307) 655-8253
Mailing address
437 SHADOW RIDGE BLVD, SHERIDAN, WY 82801-9350
(307) 655-8253
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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