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NPI Code Detail

MEDICARE: MAINSTREAM PHYSICAL THERAPY LLC

MEDICARE: MAINSTREAM PHYSICAL THERAPY LLC
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
1261QP2000XPhysical Therapy Clinic/Center002305WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669545687
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAINSTREAM PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 243 THREE SPRINGS DR STE 1
Second Line :
City : WEIRTON
State : WV
Zip : 26062-3839
Country : US
Telephone Number : 304-723-7111
Fax Number : 304-723-7173
Provider Business Practice Location Address
First Line : 243 THREE SPRINGS DR STE 1
Second Line :
City : WEIRTON
State : WV
Zip : 26062-3839
Country : US
Telephone Number : 304-723-7111
Fax Number : 304-723-7173
Authorized Official
Title or Position : DOCTOR OF PHYSICAL THERAPY
Name : JOHN IRA KIRLANGITIS
Credential : DPT
Telephone Number : 304-723-7111
Provider Enumeration Date : 11/16/2006
Last Update Date : 04/16/2025

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Directions to “MAINSTREAM PHYSICAL THERAPY LLC ” Practice Location

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