Organization
CHILDREN'S THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TORI J ROSENTHAL (MANAGING PARTNER)
(307) 635-2900
Entity
Organization
Contact information
Practice address
3718 PIONEER AVE, CHEYENNE, WY 82001-1246
(307) 635-2900
Mailing address
3718 PIONEER AVE, CHEYENNE, WY 82001-1246
(307) 635-2900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
142
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102279200
—
WY
01
—
142
LICENSE
WY
Enumeration date
07/13/2013
Last updated
07/13/2013
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