Provider Demographics
NPI:1972076511
Name:FLEMING PHYSICAL THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:FLEMING PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:503-803-4279
Mailing Address - Street 1:6324 SE IMAGINE WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-5059
Mailing Address - Country:US
Mailing Address - Phone:503-803-4279
Mailing Address - Fax:
Practice Address - Street 1:6324 SE IMAGINE WAY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-5059
Practice Address - Country:US
Practice Address - Phone:503-803-4279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy