Provider Demographics
NPI:1689456410
Name:OXLEY, ERICA BETH (PTA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:BETH
Last Name:OXLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 WINDING RD
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-8194
Mailing Address - Country:US
Mailing Address - Phone:304-991-1056
Mailing Address - Fax:
Practice Address - Street 1:400 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:WV
Practice Address - Zip Code:26362
Practice Address - Country:US
Practice Address - Phone:304-991-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPTA001493225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant