| NPI | 1801966031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT BRADLEY President 541-390-7518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4661) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4629) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-10-18 |