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1376142133
RANDY DITTMAR
LAKE OSWEGO, OR
NPI
1376142133
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 3916)
Enumeration Date
2020-10-22
Last Update Date
2021-01-14
Business Address
RANDY DITTMAR PT
17550 PROVOST ST STE 201
LAKE OSWEGO, OR 97034-5199
Phone number: 503-872-2440
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Mailing Address
RANDY DITTMAR PT
PO BOX 3158
PORTLAND, OR 97208-3158
Phone number: 503-215-6494
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