Provider Demographics
NPI:1205167210
Name:KEEN MOBILITY COMPANY
Entity type:Organization
Organization Name:KEEN MOBILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-285-9090
Mailing Address - Street 1:6500 NE HALSEY ST
Mailing Address - Street 2:BLDG B
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5092
Mailing Address - Country:US
Mailing Address - Phone:503-295-9090
Mailing Address - Fax:
Practice Address - Street 1:6500 NE HALSEY ST
Practice Address - Street 2:BLDG B
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-5092
Practice Address - Country:US
Practice Address - Phone:503-295-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty