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General NPI Number Information
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NPI Number | 1720387566
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Entity Type | Organization
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Legal Business Name | DAN R NAFZIGER L P T P C
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 5415 SW WESTGATE DR SUITE LL3
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City | PORTLAND
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State | OR
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Zip | 97221-2409
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Country | US
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Telephone | 503-297-3003
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Fax | 503-297-9414
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Provider Business Mailing Address
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Address Line | 5415 SW WESTGATE DR SUITE LL3
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City | PORTLAND
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State | OR
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Zip | 97221-2409
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Country | US
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Telephone | 503-297-3003
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Fax | 503-297-9414
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DAN R NAFZIGER
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Credential | L P T P C
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Telephone | 503-297-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1035
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License Number State | OR
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