Provider Demographics
NPI:1831706308
Name:OSPREY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC.
Entity type:Organization
Organization Name:OSPREY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-647-7332
Mailing Address - Street 1:558 SE 9TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2265
Mailing Address - Country:US
Mailing Address - Phone:541-647-7332
Mailing Address - Fax:541-640-5541
Practice Address - Street 1:558 SE 9TH ST STE 5
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2265
Practice Address - Country:US
Practice Address - Phone:541-647-7332
Practice Address - Fax:541-640-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty