Individual
CHAD G. THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
625 RAMSEY AVE, SUITE B, GRANTS PASS, OR 97527-5808
(541) 476-1919
(541) 476-1920
Mailing address
625 RAMSEY AVE, SUITE B, GRANTS PASS, OR 97527-5808
(541) 476-1919
(541) 476-1920
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4436
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286662
—
OR
01
—
J284206
PACIFIC SOURCE INSURANCE
OR
Enumeration date
07/31/2005
Last updated
12/06/2007
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