| NPI | 1548681547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BLAKE MATLOCK Owner 541-788-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 2366) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |