| NPI | 1497385215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DONALD HAGEN Director Capacity Performance Thera 541-224-7485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |