Provider Demographics
NPI:1558590166
Name:A PLACE TO HEAL INC
Entity Type:Organization
Organization Name:A PLACE TO HEAL INC
Other - Org Name:CARDINAL PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:VON SCIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:304-683-6123
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:SOPHIA
Mailing Address - State:WV
Mailing Address - Zip Code:25921-0580
Mailing Address - Country:US
Mailing Address - Phone:304-683-6123
Mailing Address - Fax:304-683-6127
Practice Address - Street 1:106 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOPHIA
Practice Address - State:WV
Practice Address - Zip Code:25921
Practice Address - Country:US
Practice Address - Phone:304-683-6123
Practice Address - Fax:304-683-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty