Provider Demographics
NPI:1508839101
Name:PARKERSBURG PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PARKERSBURG PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FABIAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:304-428-3086
Mailing Address - Street 1:4420 ROSEMAR RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1255
Mailing Address - Country:US
Mailing Address - Phone:304-428-3086
Mailing Address - Fax:304-428-5439
Practice Address - Street 1:4420 ROSEMAR RD
Practice Address - Street 2:STE 101
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1255
Practice Address - Country:US
Practice Address - Phone:304-428-3086
Practice Address - Fax:304-428-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty