Organization Name: | 212 DEGREES, LLC |
NPI Number: | 1154653400 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DUSTIN MARTINSON (OWNER) |
Mailing Address: | 1103 E Boxelder Rd Suite U Gillette |
State: | WY US |
Postal Code: | 827185582 |
Phone Number: | 3076868177 |
Fax Number: | 3076869484 |
NPI Enumeration Date: | 02/10/2010 |
NPI Last Update Date: | 10/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-1215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |