Organization
CANNON BEACH SPA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J KRUPA DC (OWNER)
(503) 436-8772
Entity
Organization
Contact information
Practice address
232 N SPRUCE ST, CANNON BEACH, OR 97110
(503) 436-8772
Mailing address
PO BOX 953, CANNON BEACH, OR 97110-0953
(503) 436-8772
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1458
OR
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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