TRAVIS JACK LEE

BEND, OR
NPI1932627924
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OR  09474)
Enumeration Date2017-08-30
Last Update Date2017-08-30
Business Address
TRAVIS JACK LEE PTA
1939 SW TROON AVE
BEND, OR 97702-3143
Phone number: 503-468-8592
Mailing Address
TRAVIS JACK LEE PTA
5020 SE 30TH AVE APT 97
PORTLAND, OR 97202-4551
Phone number: 360-540-7700
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