| Eopt Boardman Pllc | |
|
101 Sw Kinkade Rd, Boardman, OR 97818-9001 | |
| (541) 481-2533 | |
| (541) 314-4448 |
| Full Name | Eopt Boardman Pllc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 101 Sw Kinkade Rd, Boardman, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205344405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (Oregon) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (Oregon) | Primary |
| Provider Name | Amanda Carnine |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376808881 PECOS PAC ID: 7416100466 Enrollment ID: I20121227000175 |
| Provider Name | Elizabeth Shanks |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861857146 PECOS PAC ID: 5597120618 Enrollment ID: I20230425001590 |
| Mailing Address | Practice Location Address |
|---|---|
| Eopt Boardman Pllc Po Box 540640, North Salt Lake, UT 84054-0640 Ph: () - | Eopt Boardman Pllc 101 Sw Kinkade Rd, Boardman, OR 97818-9001 Ph: (541) 481-2533 |
Elizabeth Shanks, PT, DPT, LMT Physical Therapist Medicare: Medicare Enrolled Practice Location: 251 Ne Eldridge Dr, Boardman, OR 97818 Phone: 541-481-2533 Fax: 541-314-4448 | |
Brice Leion, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 101 Sw Kinkade Rd, Boardman, OR 97818 Phone: 541-481-2533 |