Individual
MR. JUSTIN PHILIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
39 NE 102ND AVE, PORTLAND, OR 97220-4103
(503) 252-2461
Mailing address
916 NE MASON ST, PORTLAND, OR 97211-3466
(518) 243-9400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6601
OR
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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