MEDICARE: DAVID ALLEN CARR PT

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	225100000X	Physical Therapist	1152	OR

General Provider Information

NPI Number	:	1740857762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALLEN CARR PT

Provider Business Mailing Address
First Line	:	21637 SW DAKOTA CIR
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-9067
Country	:	US
Telephone Number	:	503-481-2008
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 SW BORLAND RD
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-6772
Country	:	US
Telephone Number	:	503-974-8887
Fax Number	:

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

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	06/08/2021

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Directions to “ DAVID ALLEN CARR PT” Practice Location

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