Organization Name: | SOUTHSIDE PHYSICAL THERAPY, INC. |
NPI Number: | 1538161237 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA GOOLD (OWNER,OT) |
Mailing Address: | 364 Se Wilson Ave Bend |
State: | OR US |
Postal Code: | 977021711 |
Phone Number: | 5413882681 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2005 |
NPI Last Update Date: | 05/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 3911 |
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 |