Core 307 Pt LLC

NPI #1801386370 in Gillette, Wyoming

Provider Information

NPI Number: 1801386370
Entity Type: Organization
Organization Name: Core 307 Pt LLC
Primary Specialty: Physical Therapist
Enumeration Date: May 10, 2018
Last Updated: May 10, 2018

Practice Location

Address: 548 RUNNING W DR
City: Gillette
State: Wyoming
ZIP Code: 82718-2074
Phone: (307) 670-9444

Authorized Official

Name: MRS. TIFFANY CAROL CALLAWAY
Title: OFFICE MANAGER
Phone: (307) 670-9444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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