Organization
GATEWAY PARKROSE SPORTS CARE PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH J FRICKE PT (OWNER)
(503) 257-9881
Entity
Organization
Contact information
Practice address
10748 NE HALSEY ST, PORTLAND, OR 97220
(502) 257-9881
(503) 257-8964
Mailing address
10748 NE HALSEY ST, PORTLAND, OR 97220-3961
(502) 257-9881
(503) 257-8964
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1660
OR
Other
Enumeration date
02/19/2007
Last updated
09/07/2018
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