Doctor Name: | JON BURTON VAN DEN BOOGAARD |
NPI Number: | 1497185193 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 60433 |
Business Practice Address: | 735 Sw 158th Ave Suite 160 Beaverton, OR - 970064952 |
Business Phone Number: | 5035970035 |
Business Fax Number: | |
Mailing Address: | 735 Atlantic Dr, SATELLITE BEACH |
State: | FL |
Postal Code: | 329372503 |
Phone Number: | 3215359521 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2013 |
NPI Last Update Date: | 11/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 60433 |
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 |