Davis Outpatient Therapy LLC

NPI #1972268431 in Gillette, Wyoming

Provider Information

NPI Number: 1972268431
Entity Type: Organization
Organization Name: Davis Outpatient Therapy LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 1, 2021
Last Updated: Jul 25, 2022

Practice Location

Address: 902 E 3RD ST
City: Gillette
State: Wyoming
ZIP Code: 82716-4023
Phone: (307) 756-9200

Authorized Official

Name: MRS. LACY LARAE DAVIS, RN
Title: RN ADMINISTRATOR
Phone: (307) 756-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Nurse Practitioner - Family — Family	363LF0000X
Physical Therapist	225100000X	Primary

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