| NPI | 1043676711 | 
|---|---|
| Doing Business As | LAKESIDE PHYSICAL THERAPY | 
| Entity Type | Organization | 
| Authorized Contact | PAUL CALVERT Owner 304-777-3356 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy | 
| Enumeration Date | 2016-01-11 | 
| Last Update Date | 2024-11-20 |