# EASTERN OREGON PHYSICAL THERAPY HERMISTON LLC

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

## Provider details

- **NPI number:** 1124043633
- **Authorized official:** AMANDA CARNINE PT (OWNER)
- **Authorized official phone:** (406) 531-5918

## Contact information

- **Practice address:** 1725 N 1ST ST STE D, HERMISTON, OR 97838-1682
- **Practice address phone:** (541) 567-5678
- **Practice address fax:** (541) 567-2110
- **Mailing address:** PO BOX 90, SUNNYSIDE, WA 98944-0090
- **Mailing address phone:** (541) 567-5678
- **Mailing address fax:** (541) 567-2110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 110326-2401 | UT | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 12/02/2024