Organization
PHYSIO SPORT & SPINE LLC
Active
Organization
PHYSIO SPORT & SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE CHILDS EVERETT PT, DPT (PHYSICAL THERAPIST/OWNER)
(307) 421-4094
Entity
Organization
Contact information
Practice address
433 E 19TH ST, CHEYENNE, WY 82001-4643
(307) 421-4094
Mailing address
4012 ROGERS AVE, CHEYENNE, WY 82009-5560
(307) 421-4094
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0984
WY
2251X0800X
Orthopedic Physical Therapist
0984
WY
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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