Jerry Lee Cain II, PT, MPT
Physical Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1114130366
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1114130366
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jerry Lee Cain II
- Credential
- PT, MPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 7, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 3251 | OR | Yes |
Practice location
4805 Ne Glisan StPortland, OR 97213-2933
Phone 503-215-3078 · Fax 503-215-6394
Mailing address
2435 Ne 27th AvePortland, OR 97212-4852
Phone 503-234-7668 · Fax 503-215-6394
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