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SMART SPORTS MEDICINE CLINIC PC NPI 1376690214


NPI Information

NPI: 1376690214
Provider Name: SMART SPORTS MEDICINE CLINIC PC
Classification: Physical Therapist - 2251S0007X
Entity Type: Organization

Specialization: Sports

Address:
5307 YELLOWSTONE RD
CHEYENNE, WY
ZIP 82009
Phone: (307) 632-7677
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SMART SPORTS MEDICINE CLINIC PC is a sports physical therapist in Cheyenne, WY. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. SMART SPORTS MEDICINE CLINIC PC NPI is 1376690214. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5307 YELLOWSTONE RD
CHEYENNE, WY
ZIP 82009-736
Phone: (307) 632-7677
Fax: (307) 778-8292

The provider's authorized official is Vincent J Ross .
The authorized official title is Owner and has the following contact phone number (307) 632-7677.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 8/21/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251S0007XPhysical TherapistSportsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E12254MEDICARE UPINWYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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