# TUALATIN PHYSICAL THERAPY & SPORTS REHAB INC

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

## Provider details

- **NPI number:** 1407037146
- **Authorized official:** MR. BRYAN J CASPER PT (PRESIDENT)
- **Authorized official phone:** (503) 885-2199

## Contact information

- **Practice address:** 19767 SW 72ND AVE, SUITE 102, TUALATIN, OR 97062-8354
- **Practice address phone:** (503) 885-2199
- **Practice address fax:** (503) 885-2129
- **Mailing address:** 19767 SW 72ND AVE, SUITE 102, TUALATIN, OR 97062-8354
- **Mailing address phone:** (503) 885-2199
- **Mailing address fax:** (503) 885-2129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 0777 | OR | Yes |
| 225100000X | Physical Therapist | 1052 | OR | — |
| 225100000X | Physical Therapist | 1583 | OR | — |

## Other

- **Enumeration date:** 11/23/2007
- **Last updated:** 04/08/2011