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Organization
WESTON SPORTS PERFORMANCE REHABILITATION LLC
Active
Organization
WESTON SPORTS PERFORMANCE REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW LOCKE WESTON PT (OWNER)
(860) 335-2543
Entity
Organization
Contact information
Practice address
777 NW 19TH AVE APT 107, PORTLAND, OR 97209-1391
(860) 335-2543
Mailing address
777 NW 19TH AVE APT 107, PORTLAND, OR 97209-1391
(860) 335-2543
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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