| NPI | 1811201247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK OUELLETTE Owner 541-636-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5603) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2023-08-24 |