# OREGON NEUROSPORT PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1073667218
- **Authorized official:** MR. MICHAEL HOWARD BAUM BS, CFMT (PHYSICAL THERAPIST)
- **Authorized official phone:** (541) 998-9988

## Contact information

- **Practice address:** 680 IVY ST, JUNCTION CITY, OR 97448-1636
- **Practice address phone:** (541) 998-9988
- **Practice address fax:** (541) 998-9987
- **Mailing address:** PO BOX 275, JUNCTION CITY, OR 97448-0275
- **Mailing address phone:** (541) 998-9988
- **Mailing address fax:** (541) 998-9987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251N0400X | Neurology Physical Therapist | — | NULL | — |
| 2251N0400X | Neurology Physical Therapist | — | — | — |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 09/19/2017