Organization Name: | BLUEGRASS PHYSICAL THERAPY LIMITED PARTNERSHIP |
NPI Number: | 1033135280 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANNA P KING (VP-AUTHORIZED OFFICIAL) |
Mailing Address: | 1950 Bluegrass Cir Suite 110 Cheyenne |
State: | WY US |
Postal Code: | 820097323 |
Phone Number: | 3076342626 |
Fax Number: | 3076345099 |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 12/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |