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General NPI Number Information
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NPI Number | 1902913866
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Entity Type | Organization
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Legal Business Name | MARDEN REHABILITATION ASSOCIATES OF PORTAGE COUNTY, INC.
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 832 COOK PARKWAY
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City | OCEANA
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State | WV
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Zip | 24870-1930
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Country | US
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Telephone | 304-682-7100
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Fax | 304-682-7400
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Provider Business Mailing Address
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Address Line | CORNER HARDING & RT 10 COOK PARKWAY PO BOX 1930
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City | OCEANA
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State | WV
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Zip | 24870-1930
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Country | US
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Telephone | 304-682-7100
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Fax | 304-682-7400
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Authorized Official
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Title or Position | VP OF CORPORATE SERVICES
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Name | KARY PHELPS
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Credential |
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Telephone | 740-373-9446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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