| NPI | 1891825360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S. SYVERTSON President/Owner 304-573-6858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 0001489) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-04-20 |