Individual
DAVID GENCO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
319 NE RUSSET ST, PORTLAND, OR 97211-2815
(503) 289-5571
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62406
OR
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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