Provider Demographics
NPI:1093562332
Name:INNER STRENGTH PHYSICAL THERAPY
Entity type:Organization
Organization Name:INNER STRENGTH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:435-881-2474
Mailing Address - Street 1:3900 PEREGRINE ST
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-3491
Mailing Address - Country:US
Mailing Address - Phone:435-881-2474
Mailing Address - Fax:
Practice Address - Street 1:1208 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5857
Practice Address - Country:US
Practice Address - Phone:435-881-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy