Organization
DNA PHYSICAL THERAPY AND ATHLETIC CLUB, LLC
Active
Other names
DNA Physical Therapy & Athletics
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA PATRICIA BULAT PT (CO-OWNER)
(503) 308-2814
Entity
Organization
Contact information
Practice address
12305 SW HORIZON BLVD STE 201, BEAVERTON, OR 97007-9500
(971) 708-6113
(971) 708-6988
Mailing address
128 NICHOLAS WAY, NEWBERG, OR 97132-2354
(503) 423-7456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06049
OR
Other
Enumeration date
08/15/2017
Last updated
11/30/2017
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