| NPI | 1902850118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA BEASLEY Office Manager 304-253-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 000379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 001671) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-11-04 |