Individual
THOMAS JAMES BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
415 N MAIN ST, SUITE B, MERRILL, OR 97633
(541) 880-3586
(877) 552-1302
Mailing address
PO BOX 303, MERRILL, OR 97633-0303
(541) 880-3586
(877) 552-1302
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4256
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007334005
BLUE CROSS
—
05
—
228855
—
OR
01
—
A008
TRICARE
—
Enumeration date
01/03/2007
Last updated
04/09/2024
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