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General NPI Number Information
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NPI Number | 1417053042
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Entity Type | Organization
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Legal Business Name | RIVERVIEW HEALTH CLINIC, PLLC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1605 GRAND CENTRAL AVE
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City | VIENNA
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State | WV
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Zip | 26105
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Country | US
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Telephone | 304-295-5505
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Fax | 304-295-0503
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Provider Business Mailing Address
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Address Line | 1605 GRAND CENTRAL AVE
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City | VIENNA
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State | WV
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Zip | 26105
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Country | US
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Telephone | 304-295-5505
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Fax | 304-295-0503
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BECKY J MCCALE
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Credential |
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Telephone | 304-295-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 002160
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 702
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License Number State | WV
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