Healthcare Provider Details

I. General information

NPI: 1285948323
Provider Name (Legal Business Name): HUNTINGTON THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 6TH AVE FLOOR 2
HUNTINGTON WV
25701-2308
US

IV. Provider business mailing address

1018 6TH AVE FLOOR 2
HUNTINGTON WV
25701-2308
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-1155
  • Fax: 304-522-1160
Mailing address:
  • Phone: 304-522-1155
  • Fax: 304-522-1160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. TARA DOLIN
Title or Position: OWNER
Credential:
Phone: 304-522-1155