Organization
SPORTSCARE PHYSICAL THERAPY @ CORNELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JOHN FRICKE PT (MANAGING PARTNER)
(503) 257-9881
Entity
Organization
Contact information
Practice address
15390 NW CORNELL RD., SUITE 230, BEAVERTON, OR 97006
(503) 257-9881
Mailing address
15390 NW CORNELL RD., SUITE 230, BEAVERTON, OR 97006
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1660
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072538
—
OR
Enumeration date
07/03/2012
Last updated
07/03/2012
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