| Organization Name: | COUNTRY ROADS PHYSICAL THERAPY AND REHABILITATION |
| NPI Number: | 1831147297 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEREK ALAN FALKENSTEIN (PHYSICAL THERAPIST/OWNER) |
| Mailing Address: | 1509 Fairmont Avenue Fairmont |
| State: | WV US |
| Postal Code: | 265541346 |
| Phone Number: | 3043630050 |
| Fax Number: | 3043630048 |
| NPI Enumeration Date: | 05/05/2006 |
| NPI Last Update Date: | 07/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1189 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |