# PIVOTAL PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063469773
- **Authorized official:** MR. JUSTIN DAVID HARLE P.T. (OWNER)
- **Authorized official phone:** (503) 625-2217

## Contact information

- **Practice address:** 15899 SW BALER WAY, SHERWOOD, OR 97140-8833
- **Practice address phone:** (503) 625-2217
- **Practice address fax:** (503) 925-1469
- **Mailing address:** 15899 SW BALER WAY, SHERWOOD, OR 97140-8833
- **Mailing address phone:** (503) 625-2217
- **Mailing address fax:** (503) 925-1469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4428 | OR | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 07/21/2022