Healthcare Provider Details

I. General information

NPI: 1073824918
Provider Name (Legal Business Name): ELK VALLEY PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 CROSSINGS MALL RD
ELKVIEW WV
25071-9230
US

IV. Provider business mailing address

213 CROSSINGS MALL RD
ELKVIEW WV
25071-9230
US

V. Phone/Fax

Practice location:
  • Phone: 304-965-7979
  • Fax: 304-965-3239
Mailing address:
  • Phone: 304-965-7979
  • Fax: 304-965-3239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANDREA GEARY
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 304-965-7979