Individual
DYLAN FORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2040 NW NEWCASTLE ST, ROSEBURG, OR 97471-1657
(541) 673-1808
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(503) 443-6156
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63579
OR
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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