| NPI | 1669449153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE R MARSHALL BROOK Owner 503-753-1537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2600) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 225200000X Physical Therapy Assistant (Licence: OR 7585) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2023-10-24 |