Healthcare Provider Details

I. General information

NPI: 1295485084
Provider Name (Legal Business Name): DARLING PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 05/28/2022
Certification Date: 05/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 PHEASANT BLVD WELLNESS CENTER
SPRINGFIELD OR
97477
US

IV. Provider business mailing address

76 WOODLANE DR
SPRINGFIELD OR
97477-2108
US

V. Phone/Fax

Practice location:
  • Phone: 541-972-3036
  • Fax:
Mailing address:
  • Phone: 956-225-5611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIME DARLING
Title or Position: DOCTOR OF PHYSICAL THERAPY/OWNER
Credential: DPT
Phone: 541-972-3036