| NPI | 1649330457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LO LEWIS Manager 541-349-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: OR 214072) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2013-01-29 |