| |
114 Molly St, Glendale, OR 97442-3001 | |
(541) 832-2765 | |
(541) 955-5233 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 114 Molly St, Glendale, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902351489 | NPI | - | NPPES |
229162 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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544 Union Ave, Grants Pass, OR 97527-5544 Ph: (541) 476-2502 | 114 Molly St, Glendale, OR 97442-3001 Ph: (541) 832-2765 |