Active Life Physical Therapy Center Inc
Organization Active NPI Physical Therapy Clinic/Center · Brookings, OR
NPI 1962565291 · NPPES record last updated Oct 22, 2007
Key facts
- NPI
- 1962565291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 3572 (OR)
- Legal business name
- ACTIVE LIFE PHYSICAL THERAPY CENTER INC
- Practice address
- 616 Hemlock Street
A
Brookings, OR 97415-9412 - Phone
- (541) 412-1155
- NPI assigned
- Dec 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Patrick W Dodgen, PT
- Title
- Physical Therapist
- Phone
- (541) 412-3717
National Provider Directory
Locations
616 Hemlock St
Ste A
Brookings, OR 97415
Phone (541) 412-1155
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 3572 | OR | Yes |
Addresses
Primary practice location
616 Hemlock Street
A
Brookings, OR 97415-9412
Mailing address
PO Box 1628
Brookings, OR 97415-0039
Other providers in Brookings, OR
- A M M S Inc
- Activating Light Studio LLC
- Kathleen Lynnette Adamson
- Adapt
- Adapt
- Adaptive Health Consultants, LLC
- Alder Medical Center PC
All providers in Brookings, OR · Physical Therapy Clinic/Center in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.