Provider Demographics
NPI:1124268552
Name:DOWNEY, ERIN MICHELLE (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 MUSTANG TRL
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:ID
Mailing Address - Zip Code:83455-4801
Mailing Address - Country:US
Mailing Address - Phone:307-413-5415
Mailing Address - Fax:
Practice Address - Street 1:4010 W LAKE CREEK DR
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:WY
Practice Address - Zip Code:83014-9202
Practice Address - Country:US
Practice Address - Phone:307-203-2030
Practice Address - Fax:307-734-1427
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist