# BIG SKY PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1265903819
- **Authorized official:** CARL ROBERT HANSEN PT (PHYSICAL THERAPIST)
- **Authorized official phone:** (503) 472-0848

## Contact information

- **Practice address:** 609 NE BAKER ST STE 140, MCMINNVILLE, OR 97128-4907
- **Practice address phone:** (503) 472-0848
- **Practice address fax:** (503) 472-1653
- **Mailing address:** 609 NE BAKER ST STE 140, MCMINNVILLE, OR 97128-4907
- **Mailing address phone:** (503) 472-0848
- **Mailing address fax:** (503) 472-1653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2018
- **Last updated:** 04/11/2023