Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sports and Rehabilitation Center of Wyoming LLC

Organization Rehabilitation Practitioner · NPI 1063009272

Sports and Rehabilitation Center of Wyoming LLC is a Rehabilitation Practitioner in Jackson, Wyoming. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

625 E Broadway Ave
Jackson, WY 83001-8642
Phone: (307) 920-1688
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X

Record details

NPI number1063009272
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Austin Hammesfahr — Manager · (310) 307-9670
NPI enumeratedDecember 22, 2020
Last updated in NPPESMay 23, 2021
Certification dateMay 23, 2021
Mailing address522 N Sweetzer Ave Apt 5, Los Angeles, CA 90048-2659