Provider Demographics
NPI:1356578371
Name:ISELI, CRAIG WILLIAM (DPT)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:WILLIAM
Last Name:ISELI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1020 GREEN ACRES RD
Mailing Address - Street 2:SUITE #11
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-1765
Mailing Address - Country:US
Mailing Address - Phone:541-206-3329
Mailing Address - Fax:541-228-9121
Practice Address - Street 1:1020 GREEN ACRES RD
Practice Address - Street 2:SUITE #11
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-1765
Practice Address - Country:US
Practice Address - Phone:541-206-3329
Practice Address - Fax:541-228-9121
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist