Organization
SPORTSCARE PHYSICAL THERAPY @ CORNELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY TACKER (REGULATORY SPECIALIST)
(713) 297-7052
Entity
Organization
Contact information
Practice address
10121 SE SUNNYSIDE RD STE 208, CLACKAMAS, OR 97015-5750
(503) 794-1003
Mailing address
10121 SE SUNNYSIDE RD STE 208, CLACKAMAS, OR 97015-5750
(503) 794-1003
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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