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Fairway Physical Therapy, LLC

Physical Therapist in Sutherlin, OR. Organization (NPI-2).

NPI number1669924007
StatusActive
Last updated in NPPESNov 2, 2016

Details

NPI
1669924007
Entity type
Organization (NPI-2)
Legal business name
Fairway Physical Therapy, LLC
Organization subpart
No
Enumeration date
Nov 2, 2016
Last updated
Nov 2, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist02521ORYes

Practice location

211 Dakota St
Sutherlin, OR 97479-9908

Phone 541-315-2851 · Fax 541-315-2853

Mailing address

211 Dakota St
Sutherlin, OR 97479-9908

Phone 541-315-2851 · Fax 541-315-2853

Authorized official

Dan Wakefield Hirtle
Owner/ Director
5415808106

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