Provider Demographics
NPI:1649431743
Name:ACTIVE CHOICE PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:ACTIVE CHOICE PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST AND PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:541-482-4744
Mailing Address - Street 1:242 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9085
Mailing Address - Country:US
Mailing Address - Phone:541-482-4744
Mailing Address - Fax:
Practice Address - Street 1:330 OAK ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1808
Practice Address - Country:US
Practice Address - Phone:541-482-4744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2882261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy