SOUTHWEST PHYSICAL THERAPY; NPI #1518181809

Contact Information

SOUTHWEST PHYSICAL THERAPY

614 SPRUCE ST
BROOKINGS, OR 97415

Phone: 541-469-1062
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation	261QR0400X	B4[14]	Rehabilitation Agency

Indicates primary specialty

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NPI Profile & details for SOUTHWEST PHYSICAL THERAPY

NPI # 1518181809

LBN Legal business name SOUTHWEST PHYSICAL THERAPY

Authorized official CORY DORLAND - (BUSINESS MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/11/2007

Last updated 09/24/2007 - About 19 years ago

Identifiers

Medicaid

047147

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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