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1235881178
KICK PERFORMANCE THERAPY LLC
PORTLAND, OR
NPI
1235881178
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Entity Type
Organization
Authorized Contact
NATHAN EVANS
Physical Therapist
806-670-3481
Organization Subpart ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2022-01-21
Last Update Date
2022-01-21
Business Address
KICK PERFORMANCE THERAPY LLC
949 NW OVERTON ST UNIT 1508
PORTLAND, OR 97209-3278
Phone number: 806-670-3481
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Mailing Address
KICK PERFORMANCE THERAPY LLC
949 NW OVERTON ST UNIT 1508
PORTLAND, OR 97209-3278
Phone number: 806-670-3481
Copy
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