Provider Demographics
NPI:1538123005
Name:TEAYS PHYSICAL THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:TEAYS PHYSICAL THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:SKILES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:304-757-7293
Mailing Address - Street 1:3910 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9756
Mailing Address - Country:US
Mailing Address - Phone:304-757-7293
Mailing Address - Fax:304-757-0574
Practice Address - Street 1:3910 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9756
Practice Address - Country:US
Practice Address - Phone:304-757-7293
Practice Address - Fax:304-757-0574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEAYS PHYSICAL THERAPY CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-13
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4000474000Medicaid
WV9301592Medicare PIN
WV1037690001Medicare NSC
WV4000474000Medicaid
WV36126Medicare UPIN