# SAMPSON PHYSICAL THERAPY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southside Physical Therapy, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255882635
- **Authorized official:** JONATHAN P SAMPSON (PRESIDENT/OWNER)
- **Authorized official phone:** (541) 388-2681

## Contact information

- **Practice address:** 121 NW GREENWOOD AVE STE 101, BEND, OR 97703-2079
- **Practice address phone:** (541) 388-2681
- **Practice address fax:** (541) 388-9236
- **Mailing address:** 121 NW GREENWOOD AVE STE 101, BEND, OR 97703-2079
- **Mailing address phone:** (541) 388-2681
- **Mailing address fax:** (541) 388-9236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 16869140 | OR | Yes |

## Other

- **Enumeration date:** 10/20/2016
- **Last updated:** 05/17/2024