Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1237 | WY |
NPI | 1003220690 |
---|---|
Provider Name | Katie Ligocki |
First Address | Sheridan, WY 82801-3601 |
Second Address | Sheridan, WY 82801-3601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2014 |
Last Update Date | 11/06/2014 |