Organization
RESULTS NECK & BACK THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BOURLAI PT (PT, OWNER/MANAGER)
(808) 283-4139
Entity
Organization
Contact information
Practice address
730 SW BONNETT WAY, SUITE 3100, BEND, OR 97702-1192
(541) 797-6316
(541) 797-6319
Mailing address
20403 BUTTERMILK, BEND, OR 97702-9490
(541) 797-6316
(541) 797-6319
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6205
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588604649
NPI, INDIVIDUAL
—
01
—
1588915623
NPI, INDIVIDUAL
OR
05
—
500645456
—
OR
05
—
500650825
—
OR
Enumeration date
01/29/2016
Last updated
02/21/2016
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