Provider Demographics
NPI:1962098152
Name:CASCADE MOBILE PHYSICAL THERAPY
Entity type:Organization
Organization Name:CASCADE MOBILE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLGMAN-STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:320-309-9995
Mailing Address - Street 1:2333 NE MARY ROSE PL APT 1
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6798
Mailing Address - Country:US
Mailing Address - Phone:320-309-9995
Mailing Address - Fax:
Practice Address - Street 1:2333 NE MARY ROSE PL APT 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6798
Practice Address - Country:US
Practice Address - Phone:320-309-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy