Organization
CONVERGENCE PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER TANAKA PT, DPT (OWNER, PHYSICAL THERAPIST)
(808) 392-0058
Entity
Organization
Contact information
Practice address
303 S 5TH ST STE 140, SPRINGFIELD, OR 97477-5480
(541) 625-0191
Mailing address
224 W 37TH AVE, EUGENE, OR 97405-3312
(808) 392-0058
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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