Diane Vangorder P.T.A

NPI 1699959627 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1699959627
Gender Female
Enumeration Date 12/27/2007
Last Updated 12/27/2007
Entity Type Individual
Active Over 8 years ago
Practice Location
4120 KURTH ST S
SALEM OR, 97302-2724, US
Phone (503) 581-8667
Fax (503) 585-8046
Business Location
4120 KURTH ST S
SALEM OR, 97302-2724, US
Phone (503) 581-8667
Fax (503) 585-8046
Toxanomy
Taxonomy Code 225200000X
License State Oregon
License Number 7975
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According to our database, Diane Vangorder P.T.A NPI is 1699959627, taxonomy code is 225200000X and license number is 7975, license state is located at Oregon. Diane Vangorder P.T.A physically located at 4120 Kurth St S, Salem OR, 97302-2724. NPI Number Diane Vangorder P.T.A has the Individual type.

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1699959627 NPI number is provided on an as is basis without warranty of any kind. 1699959627 is maintained by the National Plan & Provider Enumeration System. The contents of Diane Vangorder P.T.A are for informational purposes only.