Most Relevant Information
Provider Data
NPI Number: | 1003334392 |
Provider Name: | DAVID GENCO DPT |
Entity Type: | Individual |
Taxonomy Code: | 225100000X |
Specialty: | Physical Therapist |
License Number: | 62406 |
Most Important Dates
Enumeration Date: | 09/06/2017 |
Last Updated: | 09/06/2017 |
Provider Practice Location
319 NE RUSSET ST
PORTLAND
OR
972112815
Practice Location Phone/Fax
Phone: | 5032895571 |
Fax: |
Provider Mailing Location
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE
OR
972224628
Provider Mailing Phone/Fax
Phone: | 9712065202 |
Fax: |