Provider Demographics
NPI:1508103409
Name:WORRELL THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:WORRELL THERAPY SERVICES LLC
Other - Org Name:MOUNTAIN VALLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-773-8118
Mailing Address - Street 1:895 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1859
Mailing Address - Country:US
Mailing Address - Phone:276-768-7081
Mailing Address - Fax:
Practice Address - Street 1:574 E MAIN ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348-3879
Practice Address - Country:US
Practice Address - Phone:276-733-6287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty