# REJUVENATION THERAPY PAIN CLINIC, LLP

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

## Provider details

- **NPI number:** 1558704221
- **Authorized official:** MINH NGUYEN (OWNER/OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (503) 851-2453

## Contact information

- **Practice address:** 1180 CROSS ST SE, SALEM, OR 97302-2924
- **Practice address phone:** (503) 999-8464
- **Practice address fax:** (503) 991-5355
- **Mailing address:** 1180 CROSS ST SE, SALEM, OR 97302-2924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/12/2013
- **Last updated:** 05/25/2021