# ACTIVE EDGE PHYSICAL THERAPY & SPORTS MEDICINE P.C.

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

## Provider details

- **NPI number:** 1730324336
- **Authorized official:** MR. DANIEL C. MORLAN PT (PRESIDENT)
- **Authorized official phone:** (503) 675-0267

## Contact information

- **Practice address:** 2020 8TH AVE STE D, WEST LINN, OR 97068-4657
- **Practice address phone:** (503) 387-5449
- **Practice address fax:** (503) 342-6846
- **Mailing address:** 2020 8TH AVE STE D, WEST LINN, OR 97068-4657
- **Mailing address phone:** (503) 387-5449
- **Mailing address fax:** (503) 342-6846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 4568 | OR | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/10/2008
- **Last updated:** 05/16/2023