# DIRECT PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1205109014
- **Authorized official:** LANCE D COOPER P.T. (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (541) 941-5170

## Contact information

- **Practice address:** 21850 HIGHWAY 62 STE 203, SHADY COVE, OR 97539-8715
- **Practice address phone:** (541) 941-5170
- **Practice address fax:** (541) 878-8111
- **Mailing address:** 997 PATTON LN, ASHLAND, OR 97520-9135
- **Mailing address phone:** (541) 941-5170
- **Mailing address fax:** (541) 878-8111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 5130 | OR | Yes |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 04/28/2025