Organization
WYOMING PHYSIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN THOMAS SWAN M.D. (M.D.)
(307) 265-7731
Entity
Organization
Contact information
Practice address
5715 E 2ND ST, CASPER, WY 82609-4322
(307) 268-7731
Mailing address
PO BOX 128, BELLAIRE, TX 77402-0128
(281) 833-3330
(281) 833-3323
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
6809A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118696500
—
WY
01
—
126432000
GROUP MEDICAID
WY
01
—
W21781
GROUP MEDICARE
WY
Enumeration date
03/07/2008
Last updated
11/24/2011
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