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Organization
SISKIYOU PHYSICAL THERAPY, PC
Active
Organization
SISKIYOU PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLE HULL DO (BILLER)
(541) 479-6936
Entity
Organization
Contact information
Practice address
1485 NE 7TH ST, GRANTS PASS, OR 97526
(541) 479-6936
Mailing address
PO BOX 2630, GRANTS PASS, OR 97528-0239
(541) 479-6936
(541) 479-6939
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4659
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000584
—
OR
Enumeration date
01/23/2007
Last updated
05/29/2018
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