Individual
RAJENDRA PUSULURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2615 PORTLAND RD NE, SALEM, OR 97301-0124
(503) 383-1053
(971) 771-0071
Mailing address
1115 MADISON ST NE # 1070, SALEM, OR 97301-7862
(503) 560-2068
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63619
OR
261QP2000X
Physical Therapy Clinic/Center
63619
OR
Other
Enumeration date
09/25/2014
Last updated
09/09/2024
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