Healthcare Provider Details

I. General information

NPI: 1144384421
Provider Name (Legal Business Name): GENERATIONS R.C., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 TEAYS VALLEY RD SUITE 100
HURRICANE WV
25526-9645
US

IV. Provider business mailing address

PO BOX 687
GREENUP KY
41144-0687
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-2500
  • Fax: 304-757-2586
Mailing address:
  • Phone: 606-473-1080
  • Fax: 606-473-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DELORIS S BENTLEY
Title or Position: EXECUTIVE VP - BUSINESS OPERATIONS
Credential:
Phone: 606-473-1080