Provider Demographics
NPI:1750303665
Name:LEMLEY, SUMMER F (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:F
Last Name:LEMLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-6234
Mailing Address - Country:US
Mailing Address - Phone:307-851-7421
Mailing Address - Fax:
Practice Address - Street 1:1205 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3871
Practice Address - Country:US
Practice Address - Phone:307-856-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY308716OtherBLUE CROSS BLUE SHIELD
WY116276400Medicaid
P27849Medicare UPIN