Provider Demographics
NPI:1891120986
Name:FALVEY, JASON R (PT, DPT, GCS, CEEAA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:FALVEY
Suffix:
Gender:M
Credentials:PT, DPT, GCS, CEEAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WALTERSCHEID BLVD
Mailing Address - Street 2:APT. F305
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007-2333
Mailing Address - Country:US
Mailing Address - Phone:207-951-0704
Mailing Address - Fax:
Practice Address - Street 1:1920 THOMES AVE
Practice Address - Street 2:STE. 100
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3542
Practice Address - Country:US
Practice Address - Phone:307-778-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY13762251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics