| Ontario Physical Therapy Pc | |
|
49 Nw 1st St, Suite 1, Ontario, OR 97914-2468 | |
| (541) 889-4550 | |
| (541) 889-4628 |
| Full Name | Ontario Physical Therapy Pc |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 49 Nw 1st St, Ontario, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003983602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 3474 (Oregon) | Secondary |
| 225X00000X | Occupational Therapist | 981352 (Oregon) | Primary |
| Provider Name | Glenn E Dodge |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417021494 PECOS PAC ID: 6901831601 Enrollment ID: I20050930000715 |
| Mailing Address | Practice Location Address |
|---|---|
| Ontario Physical Therapy Pc 49 Nw 1st St, Suite 1, Ontario, OR 97914-2468 Ph: (541) 889-4550 | Ontario Physical Therapy Pc 49 Nw 1st St, Suite 1, Ontario, OR 97914-2468 Ph: (541) 889-4550 |
Sports & Ortho Rehab Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 898 Sw 4th Ave, Ontario, OR 97914 Phone: 541-881-7330 Fax: 541-881-7334 | |
Nicole Barker, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 840 Sw 4th Ave Ste 103, Ontario, OR 97914 Phone: 541-881-7330 | |
Mr. Kent A. Taucer, OTR/MPA Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 898 Sw 4th Ave, Ontario, OR 97914 Phone: 541-881-7337 Fax: 541-881-7334 |