Organization Name: | MOUNTAIN RIVER PHYSICAL THERAPY LLC |
NPI Number: | 1255347571 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BURTON R REED (OWNER/PT) |
Mailing Address: | 63 Hospitality Lane Suite 1 Mineral Wells |
State: | WV US |
Postal Code: | 26150 |
Phone Number: | 3044898100 |
Fax Number: | 3044898191 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 05/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |