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Organization

SPORTHOPEDICS PHYSICAL THERAPY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SCOTT P BYRD P.T. (PHYSICAL THERAPIST OWNER)
(541) 776-2035
Entity
Organization

Contact information

Practice address
1060 CRATER LAKE AVE., SUITE A, MEDFORD, OR 97504
(541) 776-2035
(541) 776-2036
Mailing address
1060 CRATER LAKE AVE., SUITE A, MEDFORD, OR 97504
(541) 776-2035
(541) 776-2036

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025186000
REGENCE BLUECROSS BLUE SH
OR
05
230485
OR
Enumeration date
05/08/2007
Last updated
05/03/2011
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