Organization
BIG SKY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL ROBERT HANSEN PT (PHYSICAL THERAPIST)
(503) 472-0848
Entity
Organization
Contact information
Practice address
609 NE BAKER ST STE 140, MCMINNVILLE, OR 97128-4907
(503) 472-0848
(503) 472-1653
Mailing address
609 NE BAKER ST STE 140, MCMINNVILLE, OR 97128-4907
(503) 472-0848
(503) 472-1653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18816119922
—
OR
Enumeration date
12/07/2018
Last updated
04/11/2023
Update your record
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