Organization
DAVIS OUTPATIENT THERAPY LLC
Active
Other names
Healing Hearts Home Health Outpatient Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LACY LARAE DAVIS RN (RN ADMINISTRATOR)
(307) 756-9200
Entity
Organization
Contact information
Practice address
902 E 3RD ST, GILLETTE, WY 82716-4023
(307) 756-9200
(888) 715-6736
Mailing address
PO BOX 338, MOORCROFT, WY 82721-0338
(307) 756-9200
(888) 715-6736
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/01/2021
Last updated
07/25/2022
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