| NPI | 1801115183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA L WALICZEK Physical Therapist 503-327-4195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4954) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |