Provider Demographics
NPI:1306177282
Name:STEP & SPINE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:STEP & SPINE PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST /MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-588-6848
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759
Mailing Address - Country:US
Mailing Address - Phone:541-588-6848
Mailing Address - Fax:
Practice Address - Street 1:625 N ARROWLEAF TRAIL BLD. G
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759
Practice Address - Country:US
Practice Address - Phone:541-588-6848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-17
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3150261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy