Provider Demographics
NPI:1205631629
Name:WEST BANK PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:WEST BANK PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:307-413-5415
Mailing Address - Street 1:6671 MUSTANG TRL
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:ID
Mailing Address - Zip Code:83455-4801
Mailing Address - Country:US
Mailing Address - Phone:307-413-5415
Mailing Address - Fax:
Practice Address - Street 1:4010 W LAKE CREEK DR
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:WY
Practice Address - Zip Code:83014-9202
Practice Address - Country:US
Practice Address - Phone:307-203-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy