Healthcare Provider Details

I. General information

NPI: 1467532598
Provider Name (Legal Business Name): PRAXIS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 YELLOW WOOD WAY
BECKLEY WV
25801-7126
US

IV. Provider business mailing address

9 YELLOW WOOD WAY
BECKLEY WV
25801-7126
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-2376
  • Fax: 304-255-7120
Mailing address:
  • Phone: 304-255-2376
  • Fax: 304-255-7120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL P BATES
Title or Position: PRESIDENT PT CEO
Credential: PT
Phone: 304-255-2376