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General NPI Number Information
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NPI Number | 1922245711
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Entity Type | Organization
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Legal Business Name | PERSONAL TOUCH PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 217 BROOKSHIRE LN
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City | BECKLEY
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State | WV
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Zip | 25801-6729
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Country | US
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Telephone | 304-253-1130
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Fax | 304-253-1150
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Provider Business Mailing Address
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Address Line | 1038 N EISENHOWER DR PMB 291
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City | BECKLEY
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State | WV
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Zip | 25801-3116
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Country | US
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Telephone | 304-253-1130
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Fax | 304-253-1150
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. SHANNON D BROOKS
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Credential | PT
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Telephone | 304-253-1130
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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 | PT002068
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License Number State | WV
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