Provider Demographics
NPI:1689821910
Name:HILLSTRAND, MICHAEL LEE (PT, DPT, CKTP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:HILLSTRAND
Suffix:
Gender:M
Credentials:PT, DPT, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HARLOW RD
Mailing Address - Street 2:#203
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1233
Mailing Address - Country:US
Mailing Address - Phone:541-954-9725
Mailing Address - Fax:
Practice Address - Street 1:650 HARLOW RD
Practice Address - Street 2:#203
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1233
Practice Address - Country:US
Practice Address - Phone:541-954-9725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR51912251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic