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Organization
TGB PHYSICAL THERAPY LLC
Active
Organization
TGB PHYSICAL THERAPY LLC
Active
Other names
Tyler Baca PHYSIO
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER BACA DPT (PHYSICAL THERAPIST/ OWNER)
(805) 728-5894
Entity
Organization
Contact information
Practice address
4400 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3558
(503) 208-4413
Mailing address
4400 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3558
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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