| NPI | 1407802101 |
|---|---|
| Doing Business As | GREEN RIDGE PHYSICAL THERAPY & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | CAROL DENISE STATTON Billing/Credentialing Manager 541-299-0294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4090) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-09-11 |