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General NPI Number Information
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NPI Number | 1609009224
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Entity Type | Organization
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Legal Business Name | FITNESS PATHWAYS, LLC
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Dates
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Enumeration Date | 08/30/2009
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Last Update Date | 08/30/2009
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Provider Practice Location Address
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Address Line | 18 PITZERS CHAPEL RD
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City | MARTINSBURG
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State | WV
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Zip | 25403-6003
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Country | US
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Telephone | 304-676-6746
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Fax |
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Provider Business Mailing Address
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Address Line | 18 PITZERS CHAPEL RD
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City | MARTINSBURG
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State | WV
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Zip | 25403-6003
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Country | US
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Telephone | 304-676-6746
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | WYOMA MC CRAY
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Credential |
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Telephone | 304-676-6746
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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 | 000954
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License Number State | WV
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