Boltz, Roberta
Boltz, Roberta is an individual health care provider with primary practice located at 1909 Vista Dr , Laramie WY 82070. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Boltz, Roberta can be contacted via phone (307) 745-8851.Contact Information
Primary practice address
1909 Vista Dr
Laramie WY 82070
Phone: (307) 745-8851
Fax: (307) 742-0961
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT199 | Wyoming |
Profile Details
| NPI number | 1548240500 |
|---|---|
| LBN Legal business name | Boltz, Roberta |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Jun 11th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548240500 | NPPES |
| Wyoming | Other | 650024124 | RAILROAD MEDICARE |
| Wyoming | Other | 310762 | RAILROAD MEDICARE |
| Wyoming | MEDICAID | 104232700 | RAILROAD MEDICARE |
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