Organization
KICK PERFORMANCE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN EVANS (PHYSICAL THERAPIST)
(806) 670-3481
Entity
Organization
Contact information
Practice address
EVOLUTION HEALTHCARE AND FITNESS, 905 SE ANKENY ST, PORTLAND, OR 97214
(971) 236-7610
Mailing address
949 NW OVERTON ST UNIT 1508, PORTLAND, OR 97209-3278
(806) 670-3481
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
08/05/2025
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