Provider Demographics
NPI:1982993325
Name:THE BIOMECHANICS INSTITUTE
Entity Type:Organization
Organization Name:THE BIOMECHANICS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-834-3905
Mailing Address - Street 1:517 MARIETTA LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1917
Mailing Address - Country:US
Mailing Address - Phone:740-336-7022
Mailing Address - Fax:
Practice Address - Street 1:417 GRAND PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-4049
Practice Address - Country:US
Practice Address - Phone:304-834-3905
Practice Address - Fax:304-917-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty