Organization
LEADING EDGE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW HENNINGS DPT (OWNER)
(503) 500-5727
Entity
Organization
Contact information
Practice address
1100 LIBERTY ST SE STE 100, SALEM, OR 97302-5385
(503) 500-5727
(971) 273-2706
Mailing address
5477 BELLFLOWER ST SE, SALEM, OR 97306-1648
(503) 500-5727
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
10/06/2023
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