Organization
BROADWAY PHYSICAL THERAPY & SPORTS REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN R GROVER (OWNER)
(503) 287-6636
Entity
Organization
Contact information
Practice address
3016 NE BROADWAY ST, PORTLAND, OR 97232-1811
(503) 287-6636
(503) 287-4044
Mailing address
3016 NE BROADWAY ST, PORTLAND, OR 97232-1811
(503) 287-6636
(503) 287-4044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2270
OR
Other
Enumeration date
01/31/2007
Last updated
02/13/2026
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