Organization Name: | BACK COUNTRY PHYSICAL THERAPY LLC |
NPI Number: | 1558742981 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRETT A JENKS (PRESIDENT) |
Mailing Address: | 2240 Coffeen Ave Ste G Sheridan |
State: | WY US |
Postal Code: | 828016288 |
Phone Number: | 3074619669 |
Fax Number: | 3073330355 |
NPI Enumeration Date: | 06/11/2015 |
NPI Last Update Date: | 01/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-1552 |
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 |