Organization
GRESHAM SPORTSCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. GEORGE EISCHEN JR. PT (DIRECTOR)
(503) 491-1666
Entity
Organization
Contact information
Practice address
24076 SE STARK ST, STE. 200, GRESHAM, OR 97030-3373
(503) 491-1666
Mailing address
24076 SE STARK ST, STE. 200, GRESHAM, OR 97030-3373
(503) 491-1666
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1517
OR
Other
Enumeration date
02/21/2007
Last updated
03/22/2018
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