Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation |
261QR0400X | B4[14] | Rehabilitation Agency |
| NPI # | 1801286117 |
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| LBN Legal business name | PORTLAND WELLNESS CARE | ||||
| Authorized official | MARK HOSKO - (FOUNDER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/26/2015 | ||||
| Last updated | 04/29/2015 - About 11 years ago | ||||
| Identifiers |
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PORTLAND WELLNESS CARE
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