Organization
ROOT & BRANCH INTEGRATIVE FITNESS
Active
Parent organization
ROOT & BRANCH PHYSICAL THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROOT & BRANCH PHYSICAL THERAPY
Authorized official
ALEX DE LA PAZ PT, DPT (OWNER)
(503) 577-0318
Entity
Organization
Contact information
Practice address
1235 SE GRAND AVE, PORTLAND, OR 97214-3435
(503) 577-0318
(503) 710-9221
Mailing address
12575 SW DOUGLAS ST, PORTLAND, OR 97225-4539
(503) 577-0318
(503) 710-9221
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/06/2019
Last updated
08/29/2021
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