# PTCONNECTLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PTCONNECT Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023699964
- **Authorized official:** FAHRUELDIN DEAN EBED DPT (CEO)
- **Authorized official phone:** (503) 473-6553

## Contact information

- **Practice address:** 7468 EVERWOOD ST NE, KEIZER, OR 97303-7858
- **Practice address phone:** (503) 451-5058
- **Mailing address:** 7468 EVERWOOD ST NE, KEIZER, OR 97303-7858
- **Mailing address phone:** (503) 451-5058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/20/2021
- **Last updated:** 03/16/2022