| Organization Name: | CAMC SPORTS MEDICINE AND REHAB--CROSS LANES |
| NPI Number: | 1134256506 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLISON ELIZABETH COLE (ATHLETIC TRAINER) |
| Mailing Address: | 130 Goff Mountain Rd Cross Lanes |
| State: | WV US |
| Postal Code: | 253131419 |
| Phone Number: | 3043887055 |
| Fax Number: | 3053887058 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |