| NPI | 1437910049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAVLOVICH VERGULYANETS Member 503-208-4130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2025-11-28 |