Individual
MR. KENNETH DAVID MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
10132 SE 99TH DR, PORTLAND, OR 97086-7227
(503) 775-7799
Mailing address
10132 SE 99TH DR, PORTLAND, OR 97086-7227
(503) 775-7799
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0549
OR
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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