111TH SQUARE FITNESS AND THERAPY, LLC

PORTLAND, OR
NPI1750521985
Entity TypeOrganization
Authorized ContactLINDA JOSEPHINE SANCHEZ
Maker
503-256-5200
Organization Subpart ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OR  0355)
Additional Taxonomies225700000X Massage Therapist
(Licence: OR  15397)
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR  1333261)
Enumeration Date2009-02-27
Last Update Date2009-02-27
Business Address
111TH SQUARE FITNESS AND THERAPY, LLC
11126 NE HALSEY ST
PORTLAND, OR 97220-2021
Phone number: 503-256-5200
Mailing Address
111TH SQUARE FITNESS AND THERAPY, LLC
11126 NE HALSEY ST
PORTLAND, OR 97220-2021
Phone number: 503-256-5200