Provider Demographics
NPI:1922444744
Name:VALLEY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:VALLEY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:307-256-8846
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:WY
Mailing Address - Zip Code:82331-0668
Mailing Address - Country:US
Mailing Address - Phone:307-256-8846
Mailing Address - Fax:307-326-8106
Practice Address - Street 1:1210 RIVER STREET
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:WY
Practice Address - Zip Code:82331
Practice Address - Country:US
Practice Address - Phone:307-256-8846
Practice Address - Fax:307-326-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY833261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy