National Provider Identifier Database

SOUTHWEST PHYSICAL THERAPY
Rehabilitation


Contact Information

SOUTHWEST PHYSICAL THERAPY
913 11TH ST SE
SUITE 1
BANDON, OR97411-9168
Phone: 541-347-4314
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation 261QR0400X

* Indicates primary specialty

NPI Profile & details for SOUTHWEST PHYSICAL THERAPY

NPI Number 1669695854
Legal business name
LBN
SOUTHWEST PHYSICAL THERAPY
Authorized official CORY DORLAND - (BUSINESS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 04/10/2007
Last updated 09/24/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • OR Medicaid: 052105

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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