Organization
CALDERA PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA D'AUTEUIL PT (OWNER)
(541) 585-0313
Entity
Organization
Contact information
Practice address
57031 PONDEROSA RD, BLDG. 27 SUITE M2, SUNRIVER, OR 97707-8708
(541) 585-0313
(541) 585-0312
Mailing address
16675 MASTEN MILL DR, LA PINE, OR 97739-8708
(180) 828-3259
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
09/19/2023
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