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Contact Information

PRO PHYSICAL THERAPY LLC
20 ADAVILLE DRIVE
SUITE 10
DIAMONDVILLE, WY83116
 Phone: 307-877-1000
 Fax: 307-877-1000
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for PRO PHYSICAL THERAPY LLC

NPI Number 1164619078
LBN Legal business name PRO PHYSICAL THERAPY LLC
Authorized official DALLAS CLARK - (OWNER/PHYSICAL THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2007
Last updated 09/25/2007 - About 19 years ago
Identifiers
WY License # 802
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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