# PROMOTION PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1548681547
- **Authorized official:** WILLIAM BLAKE MATLOCK (OWNER)
- **Authorized official phone:** (541) 788-7788

## Contact information

- **Practice address:** 845 NW DELAWARE AVE, SUITE 102, BEND, OR 97701-3276
- **Practice address phone:** (541) 788-7788
- **Mailing address:** PO BOX 72, BEND, OR 97709-0072
- **Mailing address phone:** (541) 788-7788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 2366 | OR | Yes |

## Other

- **Enumeration date:** 12/18/2013
- **Last updated:** 12/18/2013