# CANBY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1992766612
- **Authorized official:** MR. LARRY DEAN KRAUT (MANAGING MEMBER)
- **Authorized official phone:** (503) 740-8847

## Contact information

- **Practice address:** 308 N IVY ST, CANBY, OR 97013-3704
- **Practice address phone:** (503) 263-6786
- **Practice address fax:** (503) 263-6451
- **Mailing address:** PO BOX 52194, DEPT CODE 960, PHOENIX, AZ 85072-2194
- **Mailing address phone:** (503) 489-1781
- **Mailing address fax:** (503) 489-1650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 3131 | OR | Yes |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 01/19/2009