| NPI | 1538304670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |