| NPI | 1467018739 |
|---|---|
| Doing Business As | ACTIVEEDGE TUALATIN |
| Entity Type | Organization |
| Authorized Contact | DANIEL C MORLAN Managing Member 503-387-5449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |