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Organization

PROACTIVE PHYSICAL THERAPY -SALMON CREEK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY KROUT (OWNER)
(503) 740-8847
Entity
Organization

Contact information

Practice address
2621 NE 134TH ST, SUITE 310, VANCOUVER, WA 98686-3036
(503) 489-1174
Mailing address
1480 NE VILLAGE ST, FAIRVIEW, OR 97024-3827

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
04/13/2010
Last updated
04/13/2010
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