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Organization
LINCOLN CITY PHYSICAL THERAPY, LLC
Active
Organization
LINCOLN CITY PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITO A MINA (DIRECTOR)
(541) 994-6252
Entity
Organization
Contact information
Practice address
3007 NE WEST DEVILS LAKE RD, LINCOLN CITY, OR 97367-5131
(541) 994-6252
Mailing address
3007 NE WEST DEVILS LAKE RD, LINCOLN CITY, OR 97367-5131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128392
—
OR
Enumeration date
02/09/2007
Last updated
03/05/2013
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