MEDICARE: JOSH FARRESTER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	225100000X	Physical Therapist	61093	OR

General Provider Information

NPI Number	:	1306227707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSH FARRESTER DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR
Second Line	:	STE 400
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-755-1793
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 SW 5TH ST
Second Line	:
City	:	MADRAS
State	:	OR
Zip	:	97741-1341
Country	:	US
Telephone Number	:	541-475-1218
Fax Number	:	541-475-7647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	04/22/2021

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Directions to “ JOSH FARRESTER DPT” Practice Location

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