| NPI | 1518148386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANNE HINES Physical Therapist 304-201-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 001555) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-20 |