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Umpqua Valley Physical Therapy LLC

Clinic/Center, Physical Therapy in Myrtle Creek, OR. Organization (NPI-2).

NPI number1790746402
StatusActive
Last updated in NPPESJul 25, 2008

Details

NPI
1790746402
Entity type
Organization (NPI-2)
Legal business name
Umpqua Valley Physical Therapy LLC
Organization subpart
No
Enumeration date
Mar 31, 2006
Last updated
Jul 25, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2000X Clinic/Center, Physical TherapyB0093ORYes

Practice location

213 Nw Second Ave
Myrtle Creek, OR 97457

Phone 541-863-8401 · Fax 541-863-8403

Mailing address

Po Box 3287
Portland, OR 97208-3287

Phone 503-489-1781 · Fax 503-489-1650

Authorized official

Larry Dean Krout
Managing Member
5037408847

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