CHILDREN'S INTENSIVE THERAPY
Physical Therapy at Raymond St, Portland, OR

License number
Oregon 60716
Category
Ambulatory Health
Type
Physical Therapy
Owner
Name: DARREN BRAULT
Title: PRESIDENT/CLINIC OWNER
Phone: (503) 895-1320
Address
Address
7203 SE Raymond St, Portland, OR 97206
National Provider ID: 1982001194
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CHILDRENS INTENSIVE THERAPY NORTHWEST INC

Happy Valley, OR  -  Portland, OR

Industry:
Specialty Outpatient Clinic
Doing business as:
Childrens Intensive Therapy Northwest
Registration:
Sep 11, 2009
Addresses:
12948 SE Winston Rd, Damascus, OR 97089 (Mailing)
7203 SE Raymond St, Portland, OR 97206 (Physical)
3810 SE Ctr St, Portland, OR 97202
State ID:
62974796
Business type:
DOMESTIC BUSINESS CORPORATION
Principal:
Darren D. Brault (Principal)
Agent:
Darren Davidbrault,12948 SE Winston Rd, Damascus, OR 97089 (Physical)

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