| NPI | 1417634049 |
|---|---|
| Doing Business As | AGESTRONG CHANNING HOUSE |
| Entity Type | Organization |
| Authorized Contact | STACI TONE Controller 971-206-5125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-02-19 |