MEDICARE: MCKINLEY GAUDET PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT004890	WV

General Provider Information

NPI Number	:	1386529436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKINLEY GAUDET PT, DPT

Provider Business Mailing Address
First Line	:	900 INDUSTRIAL PARK RD
Second Line	:
City	:	ELKINS
State	:	WV
Zip	:	26241-3560
Country	:	US
Telephone Number	:	304-621-7747
Fax Number	:	304-637-4588

Provider Business Practice Location Address
First Line	:	900 INDUSTRIAL PARK RD
Second Line	:
City	:	ELKINS
State	:	WV
Zip	:	26241-3560
Country	:	US
Telephone Number	:	304-621-7747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	04/20/2026

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Directions to “ MCKINLEY GAUDET PT, DPT” Practice Location

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