Provider Demographics
NPI:1114585825
Name:FARLEY, FAITH
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:FARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 TEAYS VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9279
Mailing Address - Country:US
Mailing Address - Phone:304-760-9664
Mailing Address - Fax:
Practice Address - Street 1:3495 TEAYS VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9279
Practice Address - Country:US
Practice Address - Phone:304-760-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT004146225100000X, 225100000X
SCPT9701PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346820669OtherNPI2