Provider Demographics
NPI:1215929393
Name:HARDY, DAVID O (MS PT OCS CSCS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:O
Last Name:HARDY
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Gender:M
Credentials:MS PT OCS CSCS
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Mailing Address - Street 1:PO BOX 1336
Mailing Address - Street 2:TREASURE VALLEY PHYSICAL THERAPY
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-1054
Mailing Address - Country:US
Mailing Address - Phone:541-889-2221
Mailing Address - Fax:541-889-3437
Practice Address - Street 1:2671 SW 4TH AVE
Practice Address - Street 2:TREASURE VALLEY PHYSICAL THERAPY
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-1833
Practice Address - Country:US
Practice Address - Phone:541-889-2221
Practice Address - Fax:541-889-2221
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OR5145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist