| Organization Name: | SOUTHWEST PHYSICAL THERAPY LLC |
| NPI Number: | 1568685766 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CORY DORLAND (BUSINESS MANAGER) |
| Mailing Address: | 279 N Central St Coquille |
| State: | OR US |
| Postal Code: | 974231241 |
| Phone Number: | 5413963341 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 09/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |