Healthcare Provider Details
I. General information
NPI: 1922157007
Provider Name (Legal Business Name): JOINT EFFORTS PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2565 NE BUTLER MARKET RD STE 2
BEND OR
97701-1587
US
IV. Provider business mailing address
2565 NE BUTLER MARKET RD STE 2
BEND OR
97701-1587
US
V. Phone/Fax
- Phone: 541-382-9268
- Fax: 541-382-6497
- Phone: 541-382-9268
- Fax: 541-382-6497
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MR.
SCOTT
ALAN
RUBY
Title or Position: PHYSICAL THERAPIST AND MEMBER
Credential: PT
Phone: 541-382-9268