| NPI | 1962805622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE BARNES Owner 971-404-6146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: OR 3153) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-08 |