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 |