Provider Demographics
NPI:1962700336
Name:ANEW THERAPY, LLC
Entity type:Organization
Organization Name:ANEW THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENAE
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:HERBIG
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR/L
Authorized Official - Phone:307-315-6184
Mailing Address - Street 1:PO BOX 1569
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82602-1569
Mailing Address - Country:US
Mailing Address - Phone:307-315-6184
Mailing Address - Fax:307-315-6185
Practice Address - Street 1:107 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2736
Practice Address - Country:US
Practice Address - Phone:307-315-6184
Practice Address - Fax:307-315-6185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-683261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy