Active Edge Physical Therapy & Sports Medicine

Organization Active NPI Physical Therapist · West Linn, OR

NPI 1174972053 · NPPES record last updated Jun 10, 2016

Key facts

NPI
1174972053
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
61684 (OR)
Legal business name
ACTIVE EDGE PHYSICAL THERAPY & SPORTS MEDICINE
Practice address
2020 8TH Ave
Suite D
West Linn, OR 97068-4657
Phone
(503) 387-5449
NPI assigned
Jun 10, 2016
Organization subpart
No

Authorized official

Name
Dan Morlan
Title
Physical Therapist
Phone
(503) 387-5449

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Active Edge PT Sports Med (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 61684 OR Yes

Addresses

Primary practice location

2020 8TH Ave
Suite D
West Linn, OR 97068-4657

Mailing address

2020 8TH Ave
Suite D
West Linn, OR 97068-4657
Phone (503) 387-5449

Other providers in West Linn, OR

All providers in West Linn, OR · Physical Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.