Organization
LONGEVITY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SELLERS PT (MANAGING MEMBER/OWNER)
(636) 288-0641
Entity
Organization
Contact information
Practice address
1655 SE UMATILLA ST, PORTLAND, OR 97202-7212
(636) 288-0641
Mailing address
1655 SE UMATILLA ST, PORTLAND, OR 97202-7212
(636) 288-0641
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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