Roger Pomeroy

Individual provider Active NPI Physical Therapist · Thermopolis, WY

NPI 1376943696 · NPPES record last updated Aug 25, 2014

Key facts

NPI
1376943696
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT-1205 (WY)
Practice address
148 E Arapahoe St
Thermopolis, WY 82443-2402
Phone
(307) 864-2146
Fax
(307) 864-2857
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT-1205WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1205 WY Yes

Addresses

Primary practice location

148 E Arapahoe St
Thermopolis, WY 82443-2402

Mailing address

PO Box 790
Thermopolis, WY 82443-0790
Phone (307) 864-2146

Other providers in Thermopolis, WY

All providers in Thermopolis, WY · Physical Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.