Canby Physical Therapy and Sports Medicine, LLC
Organization Active NPI Physical Therapy Clinic/Center · Canby, OR
NPI 1992766612 · NPPES record last updated Jan 19, 2009
Key facts
- NPI
- 1992766612
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 3131 (OR)
- Legal business name
- CANBY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
- Practice address
- 308 N Ivy St
Canby, OR 97013-3704 - Phone
- (503) 263-6786
- Fax
- (503) 263-6451
- NPI assigned
- Mar 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Larry Dean Kraut
- Title
- Managing Member
- Phone
- (503) 740-8847
Practitioners 6
-
John Steven Barresse Jr., MS ATC
-
Patrick J Gregg, MD
-
Kristi Liu, O.D.
-
Gareth Aubrey Tabor, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 3131 | OR | Yes |
Addresses
Primary practice location
308 N Ivy St
Canby, OR 97013-3704
Mailing address
PO Box 52194
Dept Code 960
Phoenix, AZ 85072-2194
Phone (503) 489-1781
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000132 | Medicaid | OR |
Other providers in Canby, OR
- Canby Eyecare Inc
- Canby Fire District 62
- Canby Healthcare Clinic LLC
- Canby Healthcare Clinic LLC
- Canby of Olympus, LLC
- Lindsey Nicole Carpenter
- Debra Marie Carson-Cropp
- Cary Dental Canby
- Michael D Cary
- Shelly Castaneda
All providers in Canby, 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 Jan 19, 2009. 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.