Most Relevant Information
Provider Data
| NPI Number: | 1003473182 |
| Provider Name: | ELISABETH THATCHER PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 60839352 |
Most Important Dates
| Enumeration Date: | 05/23/2019 |
| Last Updated: | 05/23/2019 |
Provider Practice Location
70 SW CENTURY DR STE 100
BEND
OR
977023558
Practice Location Phone/Fax
| Phone: | 8089904823 |
| Fax: |
Provider Mailing Location
74-5065 PALANI RD UNIT A
KAILUA KONA
HI
967408118
Provider Mailing Phone/Fax
| Phone: | 8089904823 |
| Fax: |