| NPI | 1942672142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY CATHERINE MARTIN Owner 541-500-1779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5148) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2021-12-13 |