Individual
JOEL THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1144 WILLAGILLESPIE RD STE 1, EUGENE, OR 97401-6711
(541) 636-4471
(541) 357-4992
Mailing address
1144 WILLAGILLESPIE RD STE 1, EUGENE, OR 97401-6711
(541) 636-4471
(541) 357-4992
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
64083
OR
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64083
OREGON BOARD OF PHYSICAL THERAPY
OR
Enumeration date
05/18/2021
Last updated
06/24/2021
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