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Organization
MANUAL MEDICINE & REHABILITATION CENTER PC, OF WA
Active
Organization
MANUAL MEDICINE & REHABILITATION CENTER PC, OF WA
Active
Other names
Dr. Ibolit
Organization subpart
No
Provider details
NPI number
Authorized official
ALDONA L PATTERSON (BILLING)
(360) 737-9665
Entity
Organization
Contact information
Practice address
18633 SE STARK ST BLDG A, PORTLAND, OR 97233-5468
(360) 737-9665
Mailing address
18633 SE STARK ST BLDG A, PORTLAND, OR 97233-5468
(360) 737-9665
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
11/23/2020
Last updated
06/08/2021
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