Healthcare Provider Details

I. General information

NPI: 1891825360
Provider Name (Legal Business Name): MASTERWORKS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 BROOK LN
DANIELS WV
25832-9693
US

IV. Provider business mailing address

PO BOX 767
DANIELS WV
25832-0767
US

V. Phone/Fax

Practice location:
  • Phone: 304-573-6858
  • Fax:
Mailing address:
  • Phone: 304-573-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0001489
License Number StateWV

VIII. Authorized Official

Name: DR. GREGORY S. SYVERTSON
Title or Position: PRESIDENT/OWNER
Credential: PT,DPT,CFT,CCI,CWCHP
Phone: 304-573-6858