Individual
JOHN LEIDHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4690 SW WASHINGTON AVE, BEAVERTON, OR 97005-0530
(503) 644-3311
(503) 627-0112
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(503) 443-6156
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63142
OR
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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