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Individual

HELENLISLE KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
404 NE PENN AVE, BEND, OR 97701
(541) 318-7041
(541) 388-3711
Mailing address
2625 SW 30TH ST, REDMOND, OR 97756-8123
(802) 338-1309

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61385
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500696238
OR
Enumeration date
10/27/2015
Last updated
07/09/2018
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