Provider Demographics
NPI:1164852992
Name:HILL, FAYE (LMT BCST)
Entity Type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LMT BCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-3338
Mailing Address - Country:US
Mailing Address - Phone:307-856-8800
Mailing Address - Fax:307-856-8808
Practice Address - Street 1:604 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3338
Practice Address - Country:US
Practice Address - Phone:307-856-8800
Practice Address - Fax:307-856-8808
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-1192172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist