Provider Demographics
NPI:1730690504
Name:NANCY ROBERTSON THERAPY
Entity type:Organization
Organization Name:NANCY ROBERTSON THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, P.T.
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MSPT, ATC
Authorized Official - Phone:307-333-2943
Mailing Address - Street 1:128 WEST COLLINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601
Mailing Address - Country:US
Mailing Address - Phone:307-333-2943
Mailing Address - Fax:307-333-2908
Practice Address - Street 1:128 WEST COLLINS DRIVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601
Practice Address - Country:US
Practice Address - Phone:307-333-2943
Practice Address - Fax:307-333-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY0378261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy