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General NPI Number Information
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NPI Number | 1821365339
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE WV PLLC
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 417 GRAND PARK DR STE 103
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City | PARKERSBURG
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State | WV
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Zip | 26105-4049
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Country | US
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Telephone | 304-916-1894
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Fax | 304-916-1891
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Provider Business Mailing Address
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Address Line | 417 GRAND PARK DR STE 103
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City | PARKERSBURG
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State | WV
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Zip | 26105-4049
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Country | US
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Telephone | 304-916-1894
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Fax | 304-916-1891
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Authorized Official
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Title or Position | OWNER
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Name | DONNA C DAVIS
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Credential | D.O.
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Telephone | 304-916-1894
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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 | PT001341
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 1380
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License Number State | WV
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