Provider Demographics
NPI:1861632705
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 ROAD
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 1:808 B ST
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-2727
Practice Address - Country:US
Practice Address - Phone:304-727-7293
Practice Address - Fax:304-727-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
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
WV4000474000Medicaid
WV9301592Medicare PIN