Provider Demographics
NPI:1053197947
Name:SISTERS PHYSICAL THERAPY, LLC.
Entity type:Organization
Organization Name:SISTERS PHYSICAL THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:ERLEBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:503-487-7025
Mailing Address - Street 1:100 LUNDGREN MILL DR.
Mailing Address - Street 2:#103
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759
Mailing Address - Country:US
Mailing Address - Phone:503-487-7025
Mailing Address - Fax:
Practice Address - Street 1:100 LUNDGREN MILL DR.
Practice Address - Street 2:#103
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759
Practice Address - Country:US
Practice Address - Phone:503-487-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy