Provider Demographics
NPI:1083155972
Name:HAND THERAPY OF WYOMING LLC
Entity Type:Organization
Organization Name:HAND THERAPY OF WYOMING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:307-756-2013
Mailing Address - Street 1:1211 S DOUGLAS HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4949
Mailing Address - Country:US
Mailing Address - Phone:307-756-2013
Mailing Address - Fax:
Practice Address - Street 1:1211 S DOUGLAS HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4949
Practice Address - Country:US
Practice Address - Phone:307-756-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY261Q00000X
332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment