Healthcare Provider Details

I. General information

NPI: 1609930379
Provider Name (Legal Business Name): GENERATIONS R.C., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3552 US ROUTE 60 E
BARBOURSVILLE WV
25504-1639
US

IV. Provider business mailing address

PO BOX 219
MILTON WV
25541-0219
US

V. Phone/Fax

Practice location:
  • Phone: 304-733-9560
  • Fax: 304-733-1141
Mailing address:
  • Phone: 304-757-2500
  • Fax: 606-473-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRENDA TARR
Title or Position: CFO
Credential:
Phone: 304-634-8353