Organization
HEALING BRIDGE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON KAYE SURAN PT (OWNER)
(541) 318-7041
Entity
Organization
Contact information
Practice address
404 NE PENN AVE, BEND, OR 97701
(541) 318-7041
(541) 388-3711
Mailing address
20813 PENNY LN, BEND, OR 97701-8750
(541) 318-7041
(541) 388-3711
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182422
—
OR
01
—
804449000
BLUE CROSS BLUE SHIELD
OR
01
—
H2548
PACIFIC SOURCE
—
Enumeration date
11/23/2005
Last updated
07/21/2022
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