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General NPI Number Information
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NPI Number | 1669545687
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Entity Type | Organization
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Legal Business Name | MAINSTREAM PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 243 THREE SPRINGS DR STE 1
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City | WEIRTON
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State | WV
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Zip | 26062-3839
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Country | US
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Telephone | 304-723-7111
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Fax | 304-723-7173
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Provider Business Mailing Address
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Address Line | 243 THREE SPRINGS DR STE 1
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City | WEIRTON
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State | WV
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Zip | 26062-3839
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Country | US
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Telephone | 304-723-7111
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Fax | 304-723-7173
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | JOHN IRA KIRLANGITIS
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Credential | DPT
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Telephone | 304-723-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 002305
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License Number State | WV
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