Healthcare Provider Details

I. General information

NPI: 1013036011
Provider Name (Legal Business Name): IRONTON PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 WAVERLY RD
HUNTINGTON WV
25704-1127
US

IV. Provider business mailing address

2700 GREENUP AVE
ASHLAND KY
41101-1953
US

V. Phone/Fax

Practice location:
  • Phone: 304-429-7381
  • Fax: 304-429-7383
Mailing address:
  • Phone: 606-324-0540
  • Fax: 606-324-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BEVERLY SHAE RITCHEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-324-0540