NPI 1124666821 · live from the CMS NPI Registry
Benchmark Physical Therapy Of Or, LLC
Physical Therapist in Molalla, OR. National Provider Identifier 1124666821, active.
NPI record
| NPI | 1124666821 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 1515 W Main St Ste E, Molalla, OR 97038 |
| Practice phone | 503-776-0970 |
| Mailing address | 6397 Lee Hwy Ste 300, Chattanooga, TN 37421 |
| Enumerated | December 13, 2019 |
| Last updated | December 13, 2019 |
| Authorized official | Kevin Johanneson, Vp Revenue Cycle |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist | 225X00000X | — |
| Speech-Language Pathologist, | 235Z00000X | — |
| Physical Therapist primary | 225100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.