Organization
VITALITY PHYSICAL THERAPY NORTHWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN GILROY (OWNER)
(503) 577-2706
Entity
Organization
Contact information
Practice address
12755 SW 69TH AVE, PORTLAND, OR 97223-8373
(503) 577-2706
Mailing address
7722 SE 31ST AVE, PORTLAND, OR 97202-8537
(503) 577-2706
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/17/2018
Last updated
10/24/2018
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