Provider Demographics
NPI:1265829816
Name:ALIGNED PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ALIGNED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:BLEAZARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-915-2065
Mailing Address - Street 1:110 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4033
Mailing Address - Country:US
Mailing Address - Phone:541-345-8895
Mailing Address - Fax:541-345-8867
Practice Address - Street 1:110 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4033
Practice Address - Country:US
Practice Address - Phone:541-345-8895
Practice Address - Fax:541-345-8867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5474261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy