Embodied Performance, Llc | |
61690 Pettigrew Rd Bend OR 97702-2422 | |
(541) 515-5213 | |
Not Available |
Full Name | Embodied Performance, Llc |
---|---|
Speciality | Counselor - Professional |
Location | 61690 Pettigrew Rd, Bend, Oregon |
Authorized Official Name and Position | Amy O'hana (OWNER/CLINICAL DIRECTOR) |
Authorized Official Contact | 5415155213 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Embodied Performance, Llc 61141 S Hwy 97 Pmb 162 Bend OR 97702-2523 Ph: (541) 515-5213 | Embodied Performance, Llc 61690 Pettigrew Rd Bend OR 97702-2422 Ph: (541) 515-5213 |
NPI Number | 1982468633 |
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Provider Enumeration Date | 02/12/2024 |
Last Update Date | 04/03/2024 |
Certification Date | 04/03/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982468633 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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