# OBSIDIAN PHYSICAL THERAPY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1215520549
- **Authorized official:** KATHARINE HOLMER DPT (OWNER/THERAPIST)
- **Authorized official phone:** (541) 497-1533

## Contact information

- **Practice address:** 2420 NE SHADOW BROOK PL, BEND, OR 97701-6498
- **Practice address phone:** (541) 497-1533
- **Mailing address:** 2660 NE HWY 20, STE 610 PMB \#452, BEND, OR 97701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/17/2021
- **Last updated:** 02/17/2021