Individual
THEODORE CORDELL HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02243
OR
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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