Individual
MR. KJELL M THORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1328 NW 6TH ST, GRANTS PASS, OR 97526-1255
(541) 476-4010
(541) 474-6310
Mailing address
PO BOX 774, GRANTS PASS, OR 97528-0066
(541) 476-4010
(541) 474-6310
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64526
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64526
BOARD OF PHYSICAL THERAPY
OR
Enumeration date
05/27/2022
Last updated
05/27/2022
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