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General NPI Number Information
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NPI Number | 1568473585
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Entity Type | Individual
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Provider Name | MARK W. MASCIO LPT
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 414 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062
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Country | US
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Telephone | 304-723-3780
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Fax | 304-723-4110
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Provider Business Mailing Address
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Address Line | 414 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062
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Country | US
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Telephone | 304-723-3780
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Fax | 304-723-4110
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT007090
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT006827L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 001071
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License Number State | WV
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