Provider Demographics
NPI:1578604765
Name:SPINE CENTER OF EUGENE, INC.
Entity Type:Organization
Organization Name:SPINE CENTER OF EUGENE, INC.
Other - Org Name:PHYSICAL THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:POAGUE
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-345-7532
Mailing Address - Street 1:1310 COBURG RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5200
Mailing Address - Country:US
Mailing Address - Phone:541-345-7532
Mailing Address - Fax:541-345-6692
Practice Address - Street 1:1310 COBURG RD
Practice Address - Street 2:SUITE 5
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5200
Practice Address - Country:US
Practice Address - Phone:541-345-7532
Practice Address - Fax:541-345-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty