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-- MIKE STUART DAVIS -- PTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1659578557
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
5415 SW WESTGATE DR STE L3, PORTLAND, OR, 972212409
Phone
(503) 297-3003
Fax
(503) 297-9414

Specialties & Taxonomies

Physical Therapy Assistant License: MT #1353
Physical Therapy Assistant Primary License: OR #8463

All Addresses

MAILING

1102 RYAN CT

WEST LINN, OR, 970684034

(503) 655-5698

LOCATION

5415 SW WESTGATE DR STE L3

PORTLAND, OR, 972212409

(503) 297-3003