| NPI | 1235120031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J FEELY Owner 503-234-4858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 1191) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: WA PT00002913) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2007-10-17 |