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General NPI Number Information
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NPI Number | 1912918079
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Entity Type | Organization
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Legal Business Name | SUMMIT PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 04/20/2008
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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 | VP
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Name | MARK W MASCIO
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Credential | LPT
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Telephone | 304-723-3780
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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 |
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License Number State |
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