Organization
ADVANCED PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY L FERGUSON MPT (OWNER)
(608) 249-6239
Entity
Organization
Contact information
Practice address
207 E HOLLY, SARATOGA, WY 82331
(307) 326-8223
Mailing address
PO BOX 1272, SARATOGA, WY 82331-1272
(608) 345-7053
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
9632-024
WI
261QP2000X
Physical Therapy Clinic/Center
Primary
PT-1763
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40358600
—
WI
01
—
41570000
MEDICAID DME
WI
Enumeration date
01/30/2008
Last updated
06/06/2018
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