| NPI | 1164553384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK P MONGER Director 541-923-7794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5164) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |