Organization
TGB PHYSICAL THERAPY LLC
Active
Other names
Tyler Baca PHYSIO
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER BACA DPT (PHYSICAL THERAPIST/ OWNER)
(805) 728-5894
Entity
Organization
Contact information
Practice address
4400 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3558
(503) 208-4413
Mailing address
4400 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3558
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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