Optimal Aqua Therapy, LLC

Internal Medicine Physician · Cheyenne, WY

Organization Active NPI

NPI number 1700408192

Practice location

611 E Carlson St Ste 117d
Cheyenne, WY 82009-4311
Phone
(307) 514-0510
Fax
(307) 514-2941

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NPI record

NPI
1700408192
Entity type
Organization (Type 2)
Enumeration date
May 8, 2020
Last updated
May 8, 2020
Certified
May 8, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Internal Medicine Physician Primary 207R00000X — —

Authorized official

Name
Dr. Paul Jordan Washburn, MD, MPH
Title
Director
Phone
(307) 514-0510

About Optimal Aqua Therapy, LLC

Optimal Aqua Therapy, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Internal Medicine Physician (code 207R00000X). The practice location is 611 E Carlson St Ste 117d, Cheyenne, WY 82009-4311. The NPI number 1700408192 was assigned on May 8, 2020 and the record was last updated on May 8, 2020.

The authorized official for this organization is Dr. Paul Jordan Washburn, MD, MPH, Director.

Frequently asked questions

What is the NPI number of Optimal Aqua Therapy, LLC?

The NPI number is 1700408192.

What is the phone number of Optimal Aqua Therapy, LLC?

The phone number listed for the practice location is (307) 514-0510.

Where is Optimal Aqua Therapy, LLC located?

611 E Carlson St Ste 117d, Cheyenne, WY 82009-4311.

What is the taxonomy code for Optimal Aqua Therapy, LLC?

The primary taxonomy code is 207R00000X – Internal Medicine Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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