Organization
WESTON SPORTS PERFORMANCE REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW LOCKE WESTON PT (OWNER)
(860) 335-2543
Entity
Organization
Contact information
Practice address
777 NW 19TH AVE APT 107, PORTLAND, OR 97209-1391
(860) 335-2543
Mailing address
777 NW 19TH AVE APT 107, PORTLAND, OR 97209-1391
(860) 335-2543
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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