| NPI | 1831234947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE BOWMAN MCCLYMONDS Administrator 304-598-4032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |