Organization
PRINEVILLE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH WAYNE SMITH P.T. (OWNER)
(541) 447-6846
Entity
Organization
Contact information
Practice address
1251 NE ELM ST, SUITE 2A, PRINEVILLE, OR 97754-1206
(541) 447-6846
(541) 447-1243
Mailing address
1251 NE ELM ST, SUITE 2A, PRINEVILLE, OR 97754-1206
(541) 447-6846
(541) 447-1243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0963
OR
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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