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Children'S Intensive Therapy

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

NPI number1982001194
StatusActive
Last updated in NPPESDec 3, 2014

Details

NPI
1982001194
Entity type
Organization (NPI-2)
Legal business name
Children'S Intensive Therapy
Organization subpart
No
Enumeration date
Dec 3, 2014
Last updated
Dec 3, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2000X Clinic/Center, Physical Therapy60716ORYes

Practice location

7203 Se Raymond St
Portland, OR 97206-4323

Phone 503-895-1320 · Fax 503-296-2319

Mailing address

7203 Se Raymond St
Portland, OR 97206-4323

Phone 503-895-1320 · Fax 503-296-2319

Authorized official

Darren Brault
President/Clinic Owner
5038951320

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