Provider Demographics
NPI:1467532598
Name:PRAXIS CORPORATION
Entity Type:Organization
Organization Name:PRAXIS CORPORATION
Other - Org Name:BODYWORKS HEALTH FITNESS REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT PT CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:304-255-2376
Mailing Address - Street 1:9 YELLOW WOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-7126
Mailing Address - Country:US
Mailing Address - Phone:304-255-2376
Mailing Address - Fax:304-255-7120
Practice Address - Street 1:9 YELLOW WOOD WAY
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-7126
Practice Address - Country:US
Practice Address - Phone:304-255-2376
Practice Address - Fax:304-255-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001710560OtherBLUE CROSS BLUE SHIELD
WV7926084OtherAETNA
WV0240019000Medicaid
WV371681200OtherFEDERAL WORKERS COMP
WV1196527OtherCIGNA
WV223194OtherCARELINK
WVCI4026OtherRAILROAD MEDICARE
WVCI4026OtherRAILROAD MEDICARE
WV=========00OtherBRICKSTREET W COMP
WV001710560OtherBLUE CROSS BLUE SHIELD