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BRADSHAW PHYSICAL THERAPY & WELLNESS CENTER LLC NPI 1609934504


NPI Information

NPI: 1609934504
Provider Name: BRADSHAW PHYSICAL THERAPY & WELLNESS CENTER LLC
Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

Address:
223 WINTERSAGE CIR UNIT A
TALENT, OR
ZIP 97540
Phone: (541) 482-3126
Get Directions

BRADSHAW PHYSICAL THERAPY & WELLNESS CENTER LLC is an orthopedic physical therapist in Talent, OR. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. BRADSHAW PHYSICAL THERAPY & WELLNESS CENTER LLC NPI is 1609934504. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

223 WINTERSAGE CIR UNIT A
TALENT, OR
ZIP 97540-515
Phone: (541) 482-3126
Fax: (541) 482-0593

The provider's authorized official is Roger B Bradshaw .
The authorized official title is Physical Therapist Business Owner and has the following contact phone number (541) 482-3126.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 2/1/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12251X0800XPhysical TherapistOrthopedic2192OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1122002900OTHEROREGONUS DEPT. OF LABOR
2230041MEDICAIDOREGON
3L5250-01OTHEROREGONPACIFICSOURCE
4838049001OTHEROREGONBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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