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Individual

ROBERT O NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
910 SW HIGHWAY 97, MADRAS PHYSICAL THERAPY GROUP, INC, SUITE 200, MADRAS, OR 97741-9247
(541) 475-2571
(541) 475-2590
Mailing address
910 SW HIGHWAY 97, MADRAS PHYSICAL THERAPY GROUP, INC, SUITE 200, MADRAS, OR 97741-9247
(541) 475-2571
(541) 475-2590

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3644
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
059333000
BLUE CROSS
05
234859
OR
Enumeration date
02/22/2007
Last updated
01/22/2016
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