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General NPI Number Information
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NPI Number | 1194452904
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Entity Type | Individual
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Provider Name | NATHANIEL R PINKERTON PTA
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Gender | Male
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 907 OAK ST
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City | KENOVA
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State | WV
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Zip | 25530-1422
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Country | US
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Telephone | 304-697-9589
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 5TH AVE STE 101
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City | HUNTINGTON
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State | WV
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Zip | 25703-1290
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Country | US
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Telephone | 304-525-4445
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Fax | 304-529-7449
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 0765255
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License Number State | OH
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