# PROACTIVE PHYSICAL THERAPY - PRINEVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prineville Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760838668
- **Authorized official:** STEVE ALSTOT (MEMBER)
- **Authorized official phone:** (503) 489-6250

## Contact information

- **Practice address:** 1251 NE ELM ST, PRINEVILLE, OR 97754-1206
- **Practice address phone:** (541) 447-6846
- **Mailing address:** 1480 NE VILLAGE ST, FAIRVIEW, OR 97024-3827
- **Mailing address phone:** (503) 489-6250
- **Mailing address fax:** (503) 489-1650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2016
- **Last updated:** 05/10/2016