| NPI | 1205697075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA CLARK Owner 541-357-3839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2025-03-06 |