Provider Demographics
NPI:1164949095
Name:GIVE US STRENGTH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:GIVE US STRENGTH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHEAMANSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-635-2388
Mailing Address - Street 1:4515 E PERSHING BLVD UNIT C
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-6093
Mailing Address - Country:US
Mailing Address - Phone:208-287-9420
Mailing Address - Fax:307-635-1730
Practice Address - Street 1:4515 E PERSHING BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-6093
Practice Address - Country:US
Practice Address - Phone:307-635-2388
Practice Address - Fax:307-635-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYPT-1287OtherSTATE LICENSE