Active Recovery and Manual Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACTIVE RECOVERY AND MANUAL PHYSICAL THERAPY, LLC

Practice address

12014 SE Schiller St
Portland, OR 97266-3258

Phone

(541) 337-0171

NPI assigned

Jun 28, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paulie Heisel, MBA, PTA

Title

Owner, Pta

Phone

(541) 337-0171

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403913600000",
    "number": "1669887691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12014 SE SCHILLER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972663258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12014 SE SCHILLER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972663258",
            "telephone_number": "541-337-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE RECOVERY AND MANUAL PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-28",
        "last_updated": "2014-06-28",
        "status": "A",
        "authorized_official_last_name": "HEISEL",
        "authorized_official_first_name": "PAULIE",
        "authorized_official_title_or_position": "OWNER, PTA",
        "authorized_official_telephone_number": "541-337-0171",
        "authorized_official_credential": "MBA, PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.