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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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