GREEN HERON PHYSICAL THERAPY LLC

PORTLAND, OR
NPI1518558469
Entity TypeOrganization
Authorized ContactMARIO URDANETA-MONCADA
Owner, Physical Therapist
661-717-9692
Organization Subpart ?No
Primary Taxonomy261QP2000X Clinic/Center Physical Therapy
Enumeration Date2021-02-02
Last Update Date2021-02-02
Business Address
GREEN HERON PHYSICAL THERAPY LLC
1706 NW 24TH AVE UNIT 96034
PORTLAND, OR 97296-6613
Phone number: 661-717-9692
Mailing Address
GREEN HERON PHYSICAL THERAPY LLC
PO BOX 96034
PORTLAND, OR 97296-6000
Phone number: 661-717-9692