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JHUN DANIELE GRUESO AGONOY PTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1982394193
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
3838 PACIFIC AVE, FOREST GROVE, OR, 971162224
Phone
(503) 357-1706
Fax
(503) 270-5023

Specialties & Taxonomies

Physical Therapy Assistant Primary License: OR #10156

All Addresses

MAILING

655 S WILLOW ST STE 128

MANCHESTER, NH, 031035723

(603) 681-9294

LOCATION

3838 PACIFIC AVE

FOREST GROVE, OR, 971162224

(503) 357-1706