Provider Demographics
NPI:1518603281
Name:WYPT
Entity Type:Organization
Organization Name:WYPT
Other - Org Name:PHYSICAL THERAPY OF WYOMING NEWCASTLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, DPT, PT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-746-2200
Mailing Address - Street 1:360 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WY
Mailing Address - Zip Code:82701-2719
Mailing Address - Country:US
Mailing Address - Phone:307-746-2200
Mailing Address - Fax:307-746-2216
Practice Address - Street 1:360 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701-2719
Practice Address - Country:US
Practice Address - Phone:307-746-2200
Practice Address - Fax:307-746-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty