Provider Demographics
NPI:1780253625
Name:RED CASTLE PHYSICAL THERAPY
Entity type:Organization
Organization Name:RED CASTLE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:307-677-4343
Mailing Address - Street 1:64 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:URIE
Mailing Address - State:WY
Mailing Address - Zip Code:82937-9008
Mailing Address - Country:US
Mailing Address - Phone:307-786-4460
Mailing Address - Fax:
Practice Address - Street 1:64 MEADOW ST
Practice Address - Street 2:
Practice Address - City:URIE
Practice Address - State:WY
Practice Address - Zip Code:82937-9008
Practice Address - Country:US
Practice Address - Phone:307-786-4460
Practice Address - Fax:307-786-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty