Doctor Name: | RYAN MACKENZIE |
NPI Number: | 1104204908 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | T61006 |
Business Practice Address: | 1475 Mount Hood Ave Woodburn, OR - 970719066 |
Business Phone Number: | 9719835206 |
Business Fax Number: | |
Mailing Address: | 685 36th Ave Ne, SALEM |
State: | OR |
Postal Code: | 973014741 |
Phone Number: | 5033718860 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2015 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | T61006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |