Provider Demographics
NPI:1518771278
Name:SCOUGALL, ALLYSON RILEY (DPT)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:RILEY
Last Name:SCOUGALL
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 1:1406 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-3239
Mailing Address - Country:US
Mailing Address - Phone:307-463-0462
Mailing Address - Fax:307-856-6459
Practice Address - Street 1:603 E CARLSON ST STE 304
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4443
Practice Address - Country:US
Practice Address - Phone:307-514-9999
Practice Address - Fax:307-514-6006
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-2461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYPT2461OtherPHYSICAL THERAPIST