Organization
ACTIVE CARE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT BRADLEY PT (PRESIDENT)
(541) 390-7518
Entity
Organization
Contact information
Practice address
18135 COTTONWOOD RD, SUNRIVER, OR 97707
(541) 390-7518
(541) 389-6272
Mailing address
1431 NW ITHACA AVE, BEND, OR 97701-2113
(541) 390-7518
(541) 389-6272
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4629
OR
225100000X
Physical Therapist
Primary
4661
OR
Other
Enumeration date
11/08/2006
Last updated
10/18/2007
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