MEDICARE: MILESTONES PHYSICAL THERAPY INC.

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	001555	WV

General Provider Information

NPI Number	:	1518148386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILESTONES PHYSICAL THERAPY INC.

Provider Business Mailing Address
First Line	:	130 GEORGE ST STE A
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-2648
Country	:	US
Telephone Number	:	304-929-2665
Fax Number	:	304-929-2667

Provider Business Practice Location Address
First Line	:	130 GEORGE ST STE A
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-2648
Country	:	US
Telephone Number	:	304-929-2665
Fax Number	:	304-929-2667

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MRS. JENNIFER ANNE HINES
Credential	:	B.S,P.T
Telephone Number	:	304-201-5122

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	11/20/2007

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