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Organization
PROMOTION PHYSICAL THERAPY
Active
Organization
PROMOTION PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BLAKE MATLOCK (OWNER)
(541) 788-7788
Entity
Organization
Contact information
Practice address
845 NW DELAWARE AVE, SUITE 102, BEND, OR 97701-3276
(541) 788-7788
Mailing address
PO BOX 72, BEND, OR 97709-0072
(541) 788-7788
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2366
OR
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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