Organization
SOUTHSIDE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA GOOLD (OWNER,OT)
(541) 388-2681
Entity
Organization
Contact information
Practice address
364 SE WILSON AVE, BEND, OR 97702-1711
(541) 388-2681
Mailing address
364 SE WILSON AVE, BEND, OR 97702-1711
(541) 388-2681
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3911
OR
Other
Enumeration date
08/11/2005
Last updated
05/10/2012
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