| NPI | 1952075962 |
|---|---|
| Doing Business As | AGESTRONG HOLLADAY PARK PLAZA |
| Entity Type | Organization |
| Authorized Contact | PHILLIP G FOGG Owner 971-206-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2025-08-28 |