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TRAVIS JACK LEE PTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1932627924
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
1939 SW TROON AVE, BEND, OR, 977023143
Phone
(503) 468-8592
Fax
(888) 394-2351

Specialties & Taxonomies

Physical Therapy Assistant Primary License: OR #09474

All Addresses

MAILING

5020 SE 30TH AVE APT 97

PORTLAND, OR, 972024551

(360) 540-7700

LOCATION

1939 SW TROON AVE

BEND, OR, 977023143

(503) 468-8592