| NPI | 1265829816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BENJAMIN BLEAZARD Co Owner 541-915-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5474) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-05-24 |