# PERFORMANCE ZONE SPORTS AND ORTHOPEDIC PHYSICAL THERAPY INC.

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

## Provider details

- **NPI number:** 1558495762
- **Authorized official:** MR. DARYL LEON IVINS PT (CLINIC DIRECTOR)
- **Authorized official phone:** (503) 371-4800

## Contact information

- **Practice address:** 2138 LANCASTER DR NE, SUITE 103, SALEM, OR 97305-1227
- **Practice address phone:** (503) 371-4800
- **Practice address fax:** (503) 371-4801
- **Mailing address:** 2138 LANCASTER DR NE, SUITE 103, SALEM, OR 97305-1227
- **Mailing address phone:** (503) 371-4800
- **Mailing address fax:** (503) 371-4801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 3584 | OR | Yes |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 07/30/2008