Doctor Name: | BRUCE MENDELSON |
NPI Number: | 1104808955 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSPT |
License Number: | 2220 |
Business Practice Address: | 849 Ne 7th Street Tai Grants Pass Grants Pass, OR - 975261634 |
Business Phone Number: | 5414790765 |
Business Fax Number: | 5414793461 |
Mailing Address: | 11481 Sw Hall Bv, Therapeutic Associates Inc Ste 201 PORTLAND |
State: | OR |
Postal Code: | 972238403 |
Phone Number: | 8002198835 |
Fax Number: | 5034431402 |
NPI Enumeration Date: | 11/17/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2220 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
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 |