Gresham Sportscare

NPI #1487789657 in Gresham, Oregon

Provider Information

NPI Number: 1487789657
Entity Type: Organization
Organization Name: Gresham Sportscare
Primary Specialty: Clinic/Center - Physical Therapy
Enumeration Date: Feb 21, 2007
Last Updated: Mar 22, 2018

Practice Location

Address: 24076 SE STARK ST
Address 2: STE. 200
City: Gresham
State: Oregon
ZIP Code: 97030-3373
Phone: (503) 491-1666

Authorized Official

Name: MR. C. GEORGE EISCHEN JR., PT
Title: DIRECTOR
Phone: (503) 491-1666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X	Primary

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