| NPI | 1982001194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN BRAULT President/Clinic Owner 503-895-1320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 60716) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |