Provider Demographics
NPI:1245390004
Name:BPM PHYSICAL THERAPY CENTER INC
Entity Type:Organization
Organization Name:BPM PHYSICAL THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALVER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:503-566-7782
Mailing Address - Street 1:233 MADRONA AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4609
Mailing Address - Country:US
Mailing Address - Phone:503-566-7782
Mailing Address - Fax:503-566-7783
Practice Address - Street 1:233 MADRONA AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4609
Practice Address - Country:US
Practice Address - Phone:503-566-7782
Practice Address - Fax:503-566-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2636261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR117028Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER