| NPI | 1821718008 |
|---|---|
| Doing Business As | AGESTRONG HEARTHSTONE |
| Entity Type | Organization |
| Authorized Contact | PHILLIP G FOGG Owner 971-206-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 225X00000X Occupational Therapist | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-02-19 |