# CORE PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1962805622
- **Authorized official:** KELLIE BARNES (OWNER)
- **Authorized official phone:** (971) 404-6146

## Contact information

- **Practice address:** 443 NE KNOTT ST, PORTLAND, OR 97212-3108
- **Practice address phone:** (971) 404-6146
- **Practice address fax:** (503) 282-1990
- **Mailing address:** 443 NE KNOTT ST, PORTLAND, OR 97212-3108
- **Mailing address phone:** (971) 404-6146
- **Mailing address fax:** (503) 282-1990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 3153 | OR | Yes |

## Other

- **Enumeration date:** 10/08/2014
- **Last updated:** 10/08/2014