Individual
BRYAN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
2525 NW LOVEJOY ST, 205, PORTLAND, OR 97210-2859
(503) 223-1856
(503) 223-1765
Mailing address
2525 NW LOVEJOY ST, S205, PORTLAND, OR 97210-2859
(503) 223-1856
(503) 223-1765
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60214
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497172373
GROUP NPI
OR
Enumeration date
08/01/2013
Last updated
06/04/2014
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