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Organization
PRIME PHYSICAL THERAPY
Active
Organization
PRIME PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ALAN BALCITA JR. PT, DPT, CSCS (PHYSICAL THERAPIST)
(541) 974-8572
Entity
Organization
Contact information
Practice address
337 UNION AVE STE D, GRANTS PASS, OR 97527-5574
(541) 974-8572
Mailing address
1205 MARCUS WAY, GRANTS PASS, OR 97527-5782
(541) 974-8572
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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