Individual
ALBERT FREDERICK VANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7320 SW HUNZIKER ST STE 203, TIGARD, OR 97223-2301
(888) 317-1019
Mailing address
955 SUNMIST CT SE, SALEM, OR 97306-1201
(541) 961-0137
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8864
OR
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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