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General NPI Number Information
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NPI Number | 1235078734
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Entity Type | Organization
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Legal Business Name | BASECAMP PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 400 SW BLUFF DR STE 210
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City | BEND
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State | OR
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Zip | 97702-1697
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Country | US
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Telephone | 541-205-9055
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Fax | 541-243-1654
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Provider Business Mailing Address
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Address Line | 2738 NE JILL AVE
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City | BEND
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State | OR
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Zip | 97701-7707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY GROSS
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Credential |
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Telephone | 503-939-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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