Fountain of Youth Physical Therapy LLC
NPI #1801115183 in Tigard, Oregon
Provider Information
- NPI Number
- 1801115183
- Entity Type
- Organization
- Organization Name
- Fountain of Youth Physical Therapy LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- May 25, 2010
- Last Updated
- May 25, 2010
Practice Location
Authorized Official
- Name
- LAURA L WALICZEK, PT, DPT
- Title
- PHYSICAL THERAPIST
- Phone
- (503) 327-4195
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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