| NPI | 1205933579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERDINAND P. SORONGON Administrator 304-768-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 1112) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |